Provider Demographics
NPI:1942648944
Name:WUSU, TIMILEHIN O (MD)
Entity type:Individual
Prefix:
First Name:TIMILEHIN
Middle Name:O
Last Name:WUSU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:MASSACHUSETTS GENERAL HOSPITAL
Mailing Address - Street 2:55 FRUIT ST.
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:617-726-2942
Mailing Address - Fax:
Practice Address - Street 1:771 OLD NORCROSS RD STE 105
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4977
Practice Address - Country:US
Practice Address - Phone:855-647-7678
Practice Address - Fax:404-847-4232
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA84194207X00000X
MAL-255376207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery