Healthcare Provider Details
I. General information
NPI: 1225533987
Provider Name (Legal Business Name): SAHEED OLALEYE SOLEYE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/26/2018
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1412 MILSTEAD AVE NE
CONYERS GA
30012-3877
US
IV. Provider business mailing address
1199 PRINCE AVE # 70
ATHENS GA
30606-2797
US
V. Phone/Fax
- Phone: 770-918-8079
- Fax:
- Phone: 706-475-7055
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 89008 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 89008 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: