Provider Demographics
NPI:1376765180
Name:EKWENCHI, ANTHONY UBA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:UBA
Last Name:EKWENCHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4585 AUSTELL RD
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1921
Mailing Address - Country:US
Mailing Address - Phone:770-948-9338
Mailing Address - Fax:770-948-5556
Practice Address - Street 1:4585 AUSTELL RD
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1921
Practice Address - Country:US
Practice Address - Phone:770-948-9338
Practice Address - Fax:770-948-5556
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0387452084H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084H0002XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyHospice and Palliative Medicine