Individual
AKINOLA O AKINTADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SURGICAL ASSISTANT
Contact information
Practice address
2167 NORTHLAKE PKWY STE 106, TUCKER, GA 30084-4103
(770) 492-8636
(770) 492-8638
Mailing address
2167 NORTHLAKE PKWY STE 106, TUCKER, GA 30084-4103
(770) 492-8636
(770) 492-8638
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
04-143
GA
Other
Enumeration date
12/07/2011
Last updated
12/07/2011
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