Individual
BRIAN IKECHUKWU UZOMBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
925 BRANCH CT STE 201, GROVETOWN, GA 30813-3325
(706) 396-3570
Mailing address
2324 FIELDCREST RD, AUGUSTA, GA 30906-9465
(404) 445-9346
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
102756
GA
207Q00000X
Family Medicine Physician
13846
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13846
RESIDENCY TRAINING PERMIT
GA
Enumeration date
06/07/2022
Last updated
08/04/2025
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