Individual
ADEFISAYO ODUWOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
80 JESSE HILL JR DR SE, STE 2E, ATLANTA, GA 30303-3031
(404) 616-4422
Mailing address
1415 HIGHWAY 85 N STE 310-296, FAYETTEVILLE, GA 30214-7738
(678) 571-2956
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
042381
GA
207RC0000X
Cardiovascular Disease Physician
Primary
042381
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000728407C
—
GA
05
—
000728407U
—
GA
05
—
000728417C
—
GA
Enumeration date
07/21/2005
Last updated
05/07/2020
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