Provider Demographics
NPI:1437671880
Name:ONUNGWE, ISRAEL O (OD)
Entity Type:Individual
Prefix:DR
First Name:ISRAEL
Middle Name:O
Last Name:ONUNGWE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:ISRAEL
Other - Middle Name:
Other - Last Name:CHUJOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3730 CARMIA DRIVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331
Mailing Address - Country:US
Mailing Address - Phone:404-344-4136
Mailing Address - Fax:404-346-7140
Practice Address - Street 1:3730 CARMIA DRIVE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331
Practice Address - Country:US
Practice Address - Phone:404-344-4136
Practice Address - Fax:404-346-7140
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5440152W00000X
GAOPT003232152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist