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Individual

OLUMIDE GBOLAHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MBBS

Contact information

Practice address
80 JESSE HILL JR DR SE, ATLANTA, GA 30303-3031
(404) 616-4307
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
37042
AL
207RX0202X
Medical Oncology Physician
Primary
89443
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5737
GEORGIA COMPOSITE MEDICAL BOARD
GA
Enumeration date
07/11/2012
Last updated
12/08/2021
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