Individual
DR. MUTIAT AGBASIONWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2161 W SPRING ST STE A, MONROE, GA 30655-3196
(770) 267-8464
Mailing address
6303 TIMBER VALLEY WAY SW, OAKWOOD, GA 30566-0220
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
98698
GA
Other
Enumeration date
06/19/2021
Last updated
12/17/2024
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