Individual
MRS. OMOTOLA ADUKE ADEBAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
106 RAM CAT ALY, SENECA, SC 29678-3244
(864) 888-4445
(864) 888-4345
Mailing address
1774 BOXWOOD DR NW, ACWORTH, GA 30102-3579
(770) 851-4003
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
RN
GA
363AM0700X
Medical Physician Assistant
Primary
18531
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4697
—
SC
Enumeration date
05/23/2013
Last updated
03/12/2015
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