Individual
DAVID OLABANJI BALOGUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5650 WISBECH WAY, ATLANTA, GA 30349-2778
(404) 397-7632
Mailing address
5650 WISBECH WAY, ATLANTA, GA 30349-2778
(404) 397-7632
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN265381
GA
Other
Enumeration date
06/05/2022
Last updated
06/05/2022
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