Individual
DR. OKORONKWO UCHENNA OGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1969 WELLNESS BLVD, MONROE, NC 28110-7763
(704) 316-5775
(704) 316-5815
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-5775
(704) 316-5815
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2009-00327
NC
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
2009-00327
NC
207R00000X
Internal Medicine Physician
2009-00327
NC
207R00000X
Internal Medicine Physician
34679
GA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
2009-00327
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000579598C
—
GA
01
—
P00290748
RAILROAD MEDICARE
GA
Enumeration date
01/16/2007
Last updated
06/15/2021
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