Individual
DR. OMOTAYO OMOLOLA AKINMADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
150 EAGLE SPRING CT, SUITE A, STOCKBRIDGE, GA 30281-6330
(678) 289-7700
Mailing address
150 EAGLE SPRING CT, SUITE A, STOCKBRIDGE, GA 30281-6330
(678) 289-7700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13939
NH
207Q00000X
Family Medicine Physician
71204
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30207918
—
NH
Enumeration date
05/14/2008
Last updated
09/29/2014
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