Individual
FIDELIA O OSINUBI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3885 PRINCETON LAKES WAY, SUITE 402, ATLANTA, GA 30331-5599
(404) 349-0496
(404) 349-6081
Mailing address
P.O. BOX 20156, ATLANTA, GA 30325
(404) 349-0496
(404) 349-6081
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
001305
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06/11/1956
BIRTH DATE
GA
05
—
778620923D
—
GA
Enumeration date
01/25/2008
Last updated
11/01/2012
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