Organization
PREMIER PRIMARY CARE CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTAIN C. OHAGWU M.D. (CEO)
(404) 766-1970
Entity
Organization
Contact information
Practice address
5820 OLD NATIONAL HWY, COLLEGE PARK, GA 30349-3838
(770) 997-1565
(770) 997-1568
Mailing address
5820 OLD NATIONAL HWY, SUITE 250, COLLEGE PARK, GA 30349-3838
(770) 997-1565
(770) 997-1568
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
039888
GA
208000000X
Pediatrics Physician
039888
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10033956
AMERIGROUP
GA
05
—
300033306A
—
GA
01
—
52624568002
BLUE CROSS BLUE SHIELD
GA
Enumeration date
03/08/2007
Last updated
07/08/2016
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