Individual
DR. OLUFEMI ABIODUN TAIWO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
110 BRAXTON CT, FAYETTEVILLE, GA 30214-1968
(678) 610-7100
(678) 610-7111
Mailing address
110 BRAXTON CT, FAYETTEVILLE, GA 30214-1968
(678) 610-7100
(678) 610-7111
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
051606
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000973629A
—
GA
05
—
000973629B
—
GA
05
—
000973629C
—
GA
Enumeration date
03/04/2006
Last updated
09/14/2022
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