Organization
CHAMP VASCULAR, LLC
Active
Other names
Peachstate Advanced Cardiac and Endovascular LLC
Organization subpart
No
Provider details
NPI number
Authorized official
OGHENERUKEVWE ODIETE (MD OWNER)
(770) 400-9588
Entity
Organization
Contact information
Practice address
1825 HIGHWAY 34 E STE 3400, NEWNAN, GA 30265-6423
(770) 500-9588
Mailing address
124 MORGAN DR, LAGRANGE, GA 30240-6361
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Enumeration date
12/02/2019
Last updated
05/06/2025
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