Individual
DR. IGWEBUIKE ONYEKABA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3375 MEMORIAL DR, DECATUR, GA 30032-2706
(470) 355-2340
(470) 355-2347
Mailing address
PO BOX 957598, DULUTH, GA 30095-9527
(470) 355-2340
(470) 355-2347
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
039650
GA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
039650
GA
208D00000X
General Practice Physician
039650
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01045490A
INDIANA LICENSE
IN
01
—
01045490B
CSR
IN
01
—
198714
NEW YORK LICENSE
NY
01
—
25MA06176700
NEW JERSEY LICENSE
NJ
Enumeration date
05/25/2006
Last updated
06/14/2023
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