Individual
DR. ABDULFATAI OLAOLU ODEMUYIWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
235 MEDICAL BLVD, SUITE B, STOCKBRIDGE, GA 30281-7218
(770) 960-8855
(678) 565-1140
Mailing address
PO BOX 870116, MORROW, GA 30287-0116
(770) 960-8855
(678) 565-1140
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
048451
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00896684B
—
GA
Enumeration date
09/06/2006
Last updated
11/19/2013
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