Individual
EMMANUEL O SOYOOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PHD
Contact information
Practice address
2169 LAWRENCEVILLE HWY, LAWRENCEVILLE, GA 30044-7710
(770) 962-3700
(770) 962-8063
Mailing address
2169 LAWRENCEVILLE HWY, LAWRENCEVILLE, GA 30044-7710
(770) 962-3700
(770) 962-8063
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
53032
GA
207V00000X
Obstetrics & Gynecology Physician
Primary
053032
GA
208000000X
Pediatrics Physician
53032
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811315000
—
WV
05
—
413053267A
—
GA
Enumeration date
07/15/2006
Last updated
12/05/2012
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