N.W. Georgia Cardiology Clinic,P.C.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

053797 Issued in GA

Legal business name

N.W. GEORGIA CARDIOLOGY CLINIC,P.C.

Practice address

3459 Acworth Due West Rd NW
Suite 559
Acworth, GA 30101-5819

Phone

(770) 529-7922

Fax

(770) 529-7931

NPI assigned

Oct 23, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Olaniyi Olabode Osofisan, M.D.

Title

M.D./Owner

Phone

(770) 529-7922

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316995200000",
    "number": "1760565808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3459 ACWORTH DUE WEST RD NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301015819",
            "telephone_number": "770-529-7922",
            "fax_number": "770-529-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3459 ACWORTH DUE WEST RD NW",
            "address_2": "SUITE 559",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301015819",
            "telephone_number": "770-529-7922",
            "fax_number": "770-529-7931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N.W. GEORGIA CARDIOLOGY CLINIC,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2011-09-26",
        "status": "A",
        "authorized_official_last_name": "OSOFISAN",
        "authorized_official_first_name": "OLANIYI",
        "authorized_official_middle_name": "OLABODE",
        "authorized_official_title_or_position": "M.D./OWNER",
        "authorized_official_telephone_number": "770-529-7922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "053797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173191749A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle L Mushtare-Hamel, PHARMD
• David Musto
• Antony Irungu Mwangi, FNP-C
• Myeyedr Optometry of Georgia, LLC (MyEyeDr.)
• Mytrip Atlanta LLC
• Naeli Healthcare LLC (Non-Emergency Medical Transportation)
• Miriam Napolitano-Magaw, LPC
• National Vision Inc (America's Best Contacts & Eyeglasses)
• Elizabeth Marie Neal
• Shadiah Negron

• Cardiovascular Disease Physician in Acworth, GA
• Providers in Acworth, GA by specialty
• Cardiovascular Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.