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Individual

DR. RAHAMAN OLATUNJI SUARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
629 NUCKOLLS RD, BOLIVAR, TN 38008-1599
(731) 658-3388
(731) 658-4079
Mailing address
725 CLIFFTVIEW RD, BOLIVAR, TN 38008-8323
(731) 658-8900
(731) 658-4079

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35933
TN
2080P0208X
Pediatric Infectious Diseases Physician
35933
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3870746
TN
Enumeration date
12/06/2005
Last updated
08/07/2007
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