Organization
OMOLARA KUTEYI MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMOLARA B KUTEYI MD (OWNER)
(404) 284-7744
Entity
Organization
Contact information
Practice address
3546 COVINGTON HWY, SUITE C, DECATUR, GA 30032-1823
(404) 284-7744
(404) 284-8006
Mailing address
1262 EMMA JEAN PL SW, MARIETTA, GA 30064-3798
(404) 284-7744
(404) 284-7744
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
053776
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
053776
LICENSE
GA
Enumeration date
05/10/2007
Last updated
12/07/2011
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