Organization
N.W. GEORGIA CARDIOLOGY CLINIC,P.C.
Active
Organization
N.W. GEORGIA CARDIOLOGY CLINIC,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLANIYI OLABODE OSOFISAN M.D. (M.D./OWNER)
(770) 529-7922
Entity
Organization
Contact information
Practice address
3459 ACWORTH DUE WEST RD NW, SUITE 559, ACWORTH, GA 30101-5819
(770) 529-7922
(770) 529-7931
Mailing address
3459 ACWORTH DUE WEST RD NW, ACWORTH, GA 30101-5819
(770) 529-7922
(770) 529-7931
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
053797
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173191749A
—
GA
Enumeration date
10/23/2006
Last updated
09/26/2011
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