Individual provider · NPI-1

Olaseni Ajibade, M.D.

Internal Medicine · Lithonia, GA

NPI number1629327598
StatusActive
Last updated in NPPESJan 18, 2024

Details

NPI
1629327598
Entity type
Individual (NPI-1)
Name
Olaseni Ajibade
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Sep 6, 2012
Certification date
Jan 18, 2024
Last updated
Jan 18, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine86155GAYes
208M00000X Hospitalist86155GA

Practice location

2801 Dekalb Medical Pkwy
Lithonia, GA 30058-4996

Phone 404-501-8000

Mailing address

3651 Wheeler Rd
Augusta, GA 30909-6426

Other practice locations

3651 Wheeler Rd
Augusta, GA 30909-6426

Phone 706-651-3232

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