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General NPI Number Information
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NPI Number | 1033790381
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Entity Type | Individual
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Provider Name | OLUWADUNSIN BAKARE MD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2021
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 3950 AUSTELL RD
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City | AUSTELL
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State | GA
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Zip | 30106-1121
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Country | US
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Telephone | 469-236-0769
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 RIDENOUR BLVD NW STE 300
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City | KENNESAW
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State | GA
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Zip | 30152-4402
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Country | US
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Telephone | 770-702-1806
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 104400
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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