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Individual

DR. NGOZI IHEUWA EZEH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD, RPA-C

Contact information

Practice address
3780 EISENHOWER PKWY, MACON, GA 31206-0800
(478) 633-0550
Mailing address
147 THE MASTERS CV, MACON, GA 31211-6005
(478) 257-6672

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
003567
GA
363AS0400X
Surgical Physician Assistant
006375-1
NY
363AS0400X
Surgical Physician Assistant
25MP00054000
NJ

Other

Enumeration date
05/20/2008
Last updated
01/23/2012
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