Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | 73911 | GA |
N | 207VX0000X | Obstetrician | 73911 | GA |
NPI | 1306136551 |
---|---|
Provider Name | Ujuka A Iloabuchi |
First Address | Snellville, GA 30078-6782 |
Second Address | Snellville, GA 30078-6782 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2011 |
Last Update Date | 01/07/2015 |