Provider Demographics
NPI:1750166583
Name:OGONJI, SOLOMON
Entity type:Individual
Prefix:
First Name:SOLOMON
Middle Name:
Last Name:OGONJI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1536
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-1536
Mailing Address - Country:US
Mailing Address - Phone:470-398-8981
Mailing Address - Fax:
Practice Address - Street 1:1399 HERRINGTON RD APT 3106
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-1209
Practice Address - Country:US
Practice Address - Phone:470-398-8981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Single Specialty