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Organization
SHITTU FAMILY PRACTICE,LLC
Active
Organization
SHITTU FAMILY PRACTICE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAWA SITOU NP (FNP)
(770) 629-1917
Entity
Organization
Contact information
Practice address
213 BANKS RD, FAYETTEVILLE, GA 30214
(770) 629-1917
Mailing address
213 BANKS STA, FAYETTEVILLE, GA 30214-7505
(770) 629-1917
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/22/2020
Last updated
05/17/2021
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