Individual
CHARLES E ORIBABOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-3609
(706) 721-8623
(706) 721-1459
Mailing address
1120 15TH ST STE OR6000, AUGUSTA, GA 30912-0004
(706) 721-3813
(706) 721-1459
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
220169
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
81915
GA
207RP1001X
Pulmonary Disease Physician
220169
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0207888
—
NJ
05
—
02172705
—
NY
01
—
P00786372
RR MEDICARE
NJ
01
—
ZK8392
HEALTHNET
NJ
Enumeration date
05/11/2006
Last updated
01/11/2023
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