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Individual

DR. EKUNDAYO ADEDAPO FALASE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1612 MILSTEAD RD NE, SUITE A, CONYERS, GA 30012-3738
(678) 413-3261
(678) 413-3580
Mailing address
PO BOX 1157, COVINGTON, GA 30015-1157

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
044714
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000924536B
GA
Enumeration date
05/24/2005
Last updated
04/14/2015
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