Provider Demographics
NPI:1437138872
Name:OLUBOWALE, FOLARIN ADEGBOYEGA (MD)
Entity type:Individual
Prefix:DR
First Name:FOLARIN
Middle Name:ADEGBOYEGA
Last Name:OLUBOWALE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1711 BUENA VISTA ROAD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-6143
Mailing Address - Country:US
Mailing Address - Phone:706-571-3300
Mailing Address - Fax:706-571-3320
Practice Address - Street 1:1711 BUENA VISTA RD
Practice Address - Street 2:SUITE 5
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-6141
Practice Address - Country:US
Practice Address - Phone:706-571-3300
Practice Address - Fax:706-571-3320
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2015-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GAGA 41348207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000728637AMedicaid
GAG41182Medicare UPIN
GA11BDLSGMedicare PIN
GA000728637AMedicaid