Organization
BRYAN MEDICAL ASSOCIATES,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADEWUNMI O SOBOWALE DO (ONWER)
(912) 876-5452
Entity
Organization
Contact information
Practice address
10164 FORD AVE, SUITE# B, RICHMOND HILL, GA 31324-3949
(912) 754-7574
Mailing address
10164 FORD AVE, SUITE# B, RICHMOND HILL, GA 31324-3949
(912) 754-7574
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
044594
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
552520214D
—
GA
Enumeration date
12/10/2008
Last updated
12/10/2008
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