Individual
OLUGBENGA OGUNLEYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
440 WINN WAY, DECATUR, GA 30030-1715
(404) 294-0499
Mailing address
440 WINN WAY, DECATUR, GA 30030-1715
(404) 294-0499
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9585553
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059817879
GEORGIA DRIVER LICENSE
GA
Enumeration date
04/18/2022
Last updated
04/20/2022
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