# CLEMENT AYANBADEJO LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** macley family practice and walk in clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811553084
- **Authorized official:** DR. CLEMENT O AYANBADEJO MD (FAMILY PHYSICIAN)
- **Authorized official phone:** (678) 257-2832

## Contact information

- **Practice address:** 2282 MEADOW CHURCH RD STE 200, DULUTH, GA 30097-5318
- **Practice address phone:** (678) 372-7880
- **Mailing address:** 2282 MEADOW CHURCH RD STE 200, DULUTH, GA 30097-5318
- **Mailing address phone:** (678) 257-2832
- **Mailing address fax:** (470) 282-1069

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/14/2019
- **Last updated:** 12/31/2020