Individual
OLUFUNKE E FADOJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
705 DIXIE ST, CARROLLTON, GA 30117-3818
(678) 301-0636
Mailing address
705 DIXIE ST, CARROLLTON, GA 30117-3818
(678) 301-0636
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
25MP00158100
NJ
363AM0700X
Medical Physician Assistant
Primary
6359
GA
Other
Enumeration date
12/13/2006
Last updated
10/16/2012
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