Individual
FRED OSARETIN OSAYI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
7583 HIGHWAY 85, RIVERDALE, GA 30274-3438
(770) 996-3495
Mailing address
7583 HIGHWAY 85, RIVERDALE, GA 30274-3438
(770) 996-3495
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002179
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
697370621D
—
GA
Enumeration date
06/02/2006
Last updated
02/27/2016
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