Provider Demographics
NPI:1750385662
Name:USIFO, OSABUOHIEN SUNDAY (MD)
Entity type:Individual
Prefix:DR
First Name:OSABUOHIEN
Middle Name:SUNDAY
Last Name:USIFO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:106 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-2917
Mailing Address - Country:US
Mailing Address - Phone:912-527-1000
Mailing Address - Fax:912-527-1155
Practice Address - Street 1:1170 SHAWNEE ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-1618
Practice Address - Country:US
Practice Address - Phone:912-920-0214
Practice Address - Fax:912-921-2004
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2021-09-13
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Provider Licenses
StateLicense IDTaxonomies
GA036472207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGO5412Medicare UPIN