Individual
DR. OLANREWAJU OLUSOLA FASUSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2503
(706) 721-7501
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2503
(706) 721-7501
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4776
GA
Other
Enumeration date
06/28/2011
Last updated
06/28/2011
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