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Individual

ADEKUNLE EMMANUEL OLUWADARE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD MSC

Contact information

Practice address
1342 AUBURN RD, DACULA, GA 30019-1674
(770) 237-8150
(678) 889-9546
Mailing address
3592 HUDDLESTONE LN, BUFORD, GA 30519-4652
(610) 800-1125

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
OEG001715
PA
152WC0802X
Corneal and Contact Management Optometrist
Primary
GA2345
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
GA2345
LICENSE TO PRACTICE OPTOMETRY
GA
Enumeration date
10/06/2005
Last updated
02/26/2025
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