Organization
HERITAGE MEDICAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLADAYO ADISA OSINUGA MD (MEDICAL DIRECTOR/OWNER)
(770) 288-3883
Entity
Organization
Contact information
Practice address
1010 PENNSYLVANIA AVENUE, HERITAGE MEDICAL GROUP, PC, MCDONOUGH, GA 30253
(770) 288-3883
(770) 288-3885
Mailing address
1010 PENNSYLVANIA AVENUE, HERITAGE MEDICAL GROUP, PC, MCDONOUGH, GA 30253
(770) 288-3883
(770) 288-3885
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
057161
GA
207R00000X
Internal Medicine Physician
Primary
51703
GA
363LA2200X
Adult Health Nurse Practitioner
RN178172NP
GA
Other
Enumeration date
01/08/2008
Last updated
03/07/2023
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