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Individual

LAWRENCE LEO GOLUSINSKI JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1080 PEACHTREE ST NE STE 12, ATLANTA, GA 30309-6857
(404) 253-3660
Mailing address
285 BOULEVARD NE, STE 640, ATLANTA, GA 30312-4205
(404) 577-7800
(404) 577-7810

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
038777
GA
207QS0010X
Sports Medicine (Family Medicine) Physician
038777
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00624357Z
GA
Enumeration date
04/26/2006
Last updated
03/30/2020
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