Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 81991 | GA |
NPI | 1912936758 |
---|---|
Provider Name | Mr. Folusho A. Tugbiyele |
First Address | Snellville, GA 30078-5639 |
Second Address | Roswell, GA 30076-4916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2006 |
Last Update Date | 16/04/2019 |