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Individual

DR. AZEEZ POPOOLA ADEDUNTAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
435 HAWTHORNE AVE, SUITE 600, ATHENS, GA 30606-2574
(706) 227-0871
(706) 227-0865
Mailing address
435 HAWTHORNE AVE, SUITE 600, ATHENS, GA 30606-2574
(706) 227-0871
(706) 227-0865

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
040293
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00670381C
GA
Enumeration date
03/15/2006
Last updated
12/06/2007
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