Individual
DR. ADESHOLA KAZEEM ADEWUNMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
677 CHURCH ST NE, BOX 111, MARIETTA, GA 30060-1101
(770) 793-7750
(770) 793-7755
Mailing address
677 CHURCH ST NE, BOX 111, MARIETTA, GA 30060-1101
(770) 793-7750
(770) 793-7755
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
064735
GA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
303015
LA
208M00000X
Hospitalist Physician
064735
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
363346743A
—
GA
05
—
363346743B
—
GA
Enumeration date
01/02/2008
Last updated
01/28/2020
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