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General NPI Number Information
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NPI Number | 1043154768
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Entity Type | Individual
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Provider Name | OMOBOSOLA OMORONIKE SALISU MD
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Gender | Female
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Dates
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Enumeration Date | 04/15/2026
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Last Update Date | 04/15/2026
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Provider Practice Location Address
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Address Line | WELLSTAR GME INTERNAL MEDICINE CLINIC (SPALDING HOSPITA 747 SOUTH 8TH STREET SUITE B
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City | GRIFFIN
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State | GA
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Zip | 30224
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Country | US
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Telephone | 470-604-8250
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Fax |
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Provider Business Mailing Address
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Address Line | 14000 DUNWOOD VALLEY DR
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City | BOWIE
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State | MD
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Zip | 20721-1243
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Country | US
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Telephone |
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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 | 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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