Provider Demographics
NPI:1235999533
Name:OBIJIOFOR, UZOMA
Entity Type:Individual
Prefix:
First Name:UZOMA
Middle Name:
Last Name:OBIJIOFOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 RUSSETWOOD LN
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-6407
Mailing Address - Country:US
Mailing Address - Phone:470-452-5632
Mailing Address - Fax:
Practice Address - Street 1:1900 10TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-3601
Practice Address - Country:US
Practice Address - Phone:706-571-1430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0000000207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine