Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 078295 | GA |
NPI | 1558687384 |
---|---|
Provider Name | Dr. Ugochukwu Onyibo Egolum |
First Address | Atlanta, GA 30374-2616 |
Second Address | Gainesville, GA 30501-3466 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2010 |
Last Update Date | 06/10/2020 |