Gani Adeboye
Individual provider Active NPI Radiologic Technologist · College Park, GA
NPI 1780089375 · NPPES record last updated Oct 26, 2014
Key facts
- NPI
- 1780089375
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Radiologic Technologist 247100000X
- Practice address
- 4854 Old National Hwy
Suite 172
College Park, GA 30337-6221 - Phone
- (404) 228-9544
- NPI assigned
- Oct 26, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | Yes |
Addresses
Primary practice location
4854 Old National Hwy
Suite 172
College Park, GA 30337-6221
Mailing address
11980 Olmstead Dr
Fayetteville, GA 30215-6687
Phone (678) 886-3821
Other providers in College Park, GA
- Dana Abraham
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- Michelle Ackal
- Anthony Britt Adams
- Chelsea Illissa Adams
- Advant Therapy Services LLC
- Agape Community Integrated Health Systems, Inc
- Agape Community Integrated Health Systems, Inc.
- Aica Orthopedics, P.C.
- Amarachukwu Akujieze
All providers in College Park, GA · Radiologic Technologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.