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Individual
DR. OLADEPO COLLINS FASORANTI
Active
Individual
DR. OLADEPO COLLINS FASORANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
001220
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001220
RESIDENCY TRAINING PERMI
GA
01
—
20787
HOSP. PHYSICIAN ID #
GA
Enumeration date
04/07/2007
Last updated
12/05/2011
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