ALPHONSUS MADUWUBA AGBAERE MT(ASCP)CLS(NCA) NPI 1760626279

NPI Information

NPI: 1760626279
Provider Name: ALPHONSUS MADUWUBA AGBAERE, MT(ASCP)CLS(NCA)
Classification: Pathology - 247ZC0005X
Entity Type: Individual

Specialization: Clinical Laboratory Director, Non-physician

Address:
1670 CLAIRMONT RD
DECATUR, GA
ZIP 30033
Phone: (404) 321-6111
Get Directions

Alphonsus Maduwuba Agbaere, MT(ASCP)CLS(NCA) is a clinical laboratory director and non-physician pathology in Decatur, GA. The provider is an individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405. Alphonsus Maduwuba Agbaere, MT(ASCP)CLS(NCA) NPI is 1760626279. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1670 CLAIRMONT RD
DECATUR, GA
ZIP 30033-004
Phone: (404) 321-6111

The enumeration date for this NPI number is 4/28/2009 and was last updated on 4/28/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	246RM2200X	Technician, Pathology	Medical Laboratory	163311	GEORGIA	No
2	247ZC0005X	Pathology	Clinical Laboratory Director, Non-physician	163311	GEORGIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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