Individual
OLUMUYIWA JOSHUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1265 HIGHWAY 54 W, SUITE 500-D, FAYETTEVILLE, GA 30214-4548
(770) 719-5625
(678) 817-7125
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
056185
GA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
85682
SC
207RP1001X
Pulmonary Disease Physician
056185
GA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
056185
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
SC
Enumeration date
09/01/2006
Last updated
09/22/2021
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