Individual
DR. KOLA OLOGUNJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3104 CREEKSIDE VILLAGE DR NW, SUITE 504, KENNESAW, GA 30144-2358
(770) 966-0778
Mailing address
3104 CREEKSIDE VILLAGE DR NW, SUITE 504, KENNESAW, GA 30144-2324
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
050548
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000972408G
—
GA
01
—
855356
BLUE CROSS BLUE SHIELD
GA
Enumeration date
07/26/2005
Last updated
05/19/2008
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