Provider Demographics
NPI:1336140904
Name:ONWUANYI, ANEKWE (MD)
Entity Type:Individual
Prefix:
First Name:ANEKWE
Middle Name:
Last Name:ONWUANYI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10945 STATE BRIDGE RD STE 401-708
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-8164
Mailing Address - Country:US
Mailing Address - Phone:770-856-0837
Mailing Address - Fax:770-410-3843
Practice Address - Street 1:80 JESSIE HILL JR DRIVE
Practice Address - Street 2:STE 2E
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303
Practice Address - Country:US
Practice Address - Phone:404-616-4422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058088207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000972397AMedicaid
GA000972397BMedicaid
GA14N641Medicare PIN
GA000972397BMedicaid