Individual
DR. ANTHONY ILUYOMADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
58 BIG A RD, TOCCOA, GA 30577
(706) 886-3148
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
80455
GA
207RN0300X
Nephrology Physician
A143245
CA
Other
Enumeration date
10/23/2014
Last updated
01/11/2021
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