Individual
DR. ADEBOWALE OGUNSEYE OGUNTOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
663 LANIER PARK DR, GAINESVILLE, GA 30501-2059
(678) 450-0202
(678) 450-0080
Mailing address
663 LANIER PARK DR, GAINESVILLE, GA 30501-2059
(678) 450-0202
(678) 450-0080
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
212959
NY
207RN0300X
Nephrology Physician
Primary
97988
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000025670
EXCELLUS PROVIDER NUMBER
NY
05
—
02076084
—
NY
Enumeration date
11/18/2005
Last updated
12/21/2023
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