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Individual

JULIUS B ODERINDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D .

Contact information

Practice address
5403 SANDY LK E, LITHONIA, GA 30038-3944
(478) 714-6901
Mailing address
5403 SANDY LK E, LITHONIA, GA 30038-3944
(478) 714-6901

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
036658
GA
207Q00000X
Family Medicine Physician
Primary
36658
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
F69487
GA
Enumeration date
10/04/2006
Last updated
12/10/2016
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