Provider Demographics
NPI:1982932745
Name:ABUNYEWA, AMMA (MD)
Entity Type:Individual
Prefix:
First Name:AMMA
Middle Name:
Last Name:ABUNYEWA
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 1:4180 PROVIDENCE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-6187
Mailing Address - Country:US
Mailing Address - Phone:770-973-4749
Mailing Address - Fax:
Practice Address - Street 1:4180 PROVIDENCE RD STE 105
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-6187
Practice Address - Country:US
Practice Address - Phone:770-973-4749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-05
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.094507207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine