Organization
BOLA SOGADE, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOLA SOGADE MD (CEO)
(478) 745-3014
Entity
Organization
Contact information
Practice address
639 HEMLOCK ST, MACON, GA 31201-6886
(478) 745-3014
Mailing address
639 HEMLOCK ST, MACON, GA 31201-6886
(478) 745-3014
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6409
GA
Other
Enumeration date
04/24/2012
Last updated
04/24/2012
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