Individual
OLUGBENGA A AWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
514 S MAIN ST STE A, HINESVILLE, GA 31313
(912) 448-2000
(912) 448-2345
Mailing address
514 S MAIN ST STE A, HINESVILLE, GA 31313-4355
(912) 448-2000
(912) 448-2345
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
048329
GA
207R00000X
Internal Medicine Physician
35073659A
OH
207R00000X
Internal Medicine Physician
48329
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11SCGCS
MEDICARE PTAN
GA
05
—
2031607
—
OH
05
—
694476929A
—
GA
Enumeration date
09/14/2005
Last updated
11/14/2018
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