Doctor Name: | MR. EFIONG E. MBABA |
NPI Number: | 1477763654 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | REGISTERED NURSE |
License Number: | 06-19916 |
Business Practice Address: | 804 Commerce Blvd Suite A-32 Riverdale, GA - 302963321 |
Business Phone Number: | 7709070194 |
Business Fax Number: | 7709070195 |
Mailing Address: | 804 Commerce Blvd, Suite A-32 RIVERDALE |
State: | GA |
Postal Code: | 302963321 |
Phone Number: | 7709070194 |
Fax Number: | 7709070195 |
NPI Enumeration Date: | 05/23/2007 |
NPI Last Update Date: | 04/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 06-19916 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |