Andrew C Agwunobi, MD
Individual provider Active NPI Pediatrics Physician · Peachtree City, GA
NPI 1336214931 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1336214931
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 050336 (GA)
- Practice address
- 526 Crosstown Rd
Peachtree City, GA 30269-2916 - Phone
- (770) 692-1914
- Fax
- (770) 692-1919
- NPI assigned
- Nov 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health E Station | Past |
Accepting new patients | |
| Dignity Health | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 050336 | GA | Yes |
Addresses
Primary practice location
526 Crosstown Rd
Peachtree City, GA 30269-2916
Mailing address
526 Crosstown Rd
Peachtree City, GA 30269-2916
Phone (770) 692-1914
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All providers in Peachtree City, GA · Pediatrics Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.