Individual
DR. ADESOLA OMOTAYO FABAYO
Active
Individual
DR. ADESOLA OMOTAYO FABAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
45782
GA
207L00000X
Anesthesiology Physician
Primary
045782
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
045782
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000870669B
—
GA
05
—
00870669A
—
GA
Enumeration date
05/11/2006
Last updated
07/16/2019
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