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Individual

MINKAILU SESAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
852 DACULA RD, DACULA, GA 30019-3185
(770) 848-9380
(770) 848-9381
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
055700
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10065391
AMERIGROUP
GA
01
349829
WELLCARE
GA
05
435245270E
GA
01
52171977-006
BCBS
GA
05
G55700
SC
01
P00286027
RR MEDICARE
GA
Enumeration date
05/25/2006
Last updated
10/07/2020
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