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1003561705
OLUFEMI OLAWALE FANUSI
STONECREST, GA
NPI
1003561705
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: GA RN285470)
Enumeration Date
2022-02-21
Last Update Date
2022-02-21
Business Address
Mr. OLUFEMI OLAWALE FANUSI
4202 KENSINGTON CIR
STONECREST, GA 30038-3239
Phone number: 678-680-9209
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Mailing Address
Mr. OLUFEMI OLAWALE FANUSI
4202 KENSINGTON CIR
STONECREST, GA 30038-3239
Phone number: 678-680-9209
Copy
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