Okungbowa, Osaretin Daniel

Okungbowa, Osaretin Daniel is an sole proprietor health care provider with primary practice located at 23 Lester Rd , Statesboro GA 30458-4700. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Okungbowa, Osaretin Daniel can be contacted via phone (912) 225-1836.

Contact Information

Primary practice address
23 Lester Rd Statesboro GA 30458-4700
Fax: (912) 225-0645
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD2009-0144 New Mexico
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 62926 Georgia

Profile Details

NPI number 1740474154
LBN Legal business name Okungbowa, Osaretin Daniel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 29th, 2007
Last updated Jan 20th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740474154 NPPES
Georgia MEDICAID 420313629A

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