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Organization
MEDIC ONE LLC
Active
Organization
MEDIC ONE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADESUPO OSHIYOYE (TREASURER)
(770) 894-3167
Entity
Organization
Contact information
Practice address
2621 SANDY PLAINS RD, SUITE 304, MARIETTA, GA 30066-4267
(770) 894-3167
(770) 575-0879
Mailing address
PO BOX 670508, MARIETTA, GA 30066-0126
(770) 894-3167
(770) 575-0879
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
51736
GA
Other
Enumeration date
05/08/2012
Last updated
05/08/2012
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