Individual
SAMUEL O TENIOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
285 BOULEVARD NE, SUITE 435, ATLANTA, GA 30312-4205
(404) 524-8950
Mailing address
945 LINSLEY WAY, STONE MOUNTAIN, GA 30087-6083
(770) 879-9659
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
049349
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000891514B
—
GA
Enumeration date
07/10/2005
Last updated
07/08/2007
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