Individual
MR. ADEWALE ANTHONY ODERINDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
503 BLUE BONNET TRL, BONAIRE, GA 31005-3759
(478) 284-6452
(478) 225-6609
Mailing address
503 BLUE BONNET TRL, BONAIRE, GA 31005-3759
(478) 284-6452
(478) 225-6609
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN184424
GA
Other
Enumeration date
10/03/2016
Last updated
10/03/2016
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