Provider Demographics
NPI:1932196813
Name:PUPLAMPU, OUANZA ADIKI (MD)
Entity Type:Individual
Prefix:
First Name:OUANZA
Middle Name:ADIKI
Last Name:PUPLAMPU
Suffix:
Gender:F
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:PO BOX 6005
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30604-6005
Mailing Address - Country:US
Mailing Address - Phone:706-549-1111
Mailing Address - Fax:706-549-1122
Practice Address - Street 1:740 PRINCE AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-5909
Practice Address - Country:US
Practice Address - Phone:706-549-1111
Practice Address - Fax:706-549-1122
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056619207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology