Organization
AMERICAN BRAIN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADEREMI DOSUNMU M.D. (CEO)
(912) 877-9111
Entity
Organization
Contact information
Practice address
938 ELMA G MILES PKWY, HINESVILLE, GA 31313-4515
(912) 877-9111
(912) 877-5437
Mailing address
938 ELMA G MILES PKWY, HINESVILLE, GA 31313-4515
(912) 877-9111
(912) 877-5437
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
047893
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
802238916A
—
GA
Enumeration date
01/07/2014
Last updated
01/07/2014
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