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Organization

THEADVANCEDMED LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ONYEBUCHI NWAOKOLO DNP (CEO)
(404) 706-6371
Entity
Organization

Contact information

Practice address
1505 PENNSYLVANIA AVE, MCDONOUGH, GA 30253-9114
(404) 706-6371
Mailing address
1012 SPANIEL TER, HAMPTON, GA 30228-5951
(404) 218-8934

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
261QM1300X
Multi-Specialty Clinic/Center
Primary
363LP2300X
Primary Care Nurse Practitioner

Other

Enumeration date
03/11/2024
Last updated
03/11/2024
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