Organization
COVENANT MEDICAL CENTER PC
Active
Organization
COVENANT MEDICAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CECILIA O BABALOLA MD (PHYSICIAN/OWNER)
(678) 357-1282
Entity
Organization
Contact information
Practice address
3970 FIVE FORKS TRICKUM RD SW, SUITE A, LILBURN, GA 30047-2339
(678) 357-1282
Mailing address
3970 FIVE FORKS TRICKUM RD SW, SUITE A, LILBURN, GA 30047-2339
(678) 357-1282
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
058389
GA
Other
Enumeration date
04/07/2009
Last updated
04/20/2010
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