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Individual

OGO I EGBUNA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 PEARL ST, SUITE 1000, BROCKTON, MA 02301-2864
(508) 897-6090
(508) 897-6075
Mailing address
6 HIGHPOINT CIR, APT 707, QUINCY, MA 02169-4659
(516) 908-3845

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
223479
MA

Other

Enumeration date
11/22/2005
Last updated
07/08/2007
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