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General NPI Number Information
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NPI Number | 1609873934
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Entity Type | Individual
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Provider Name | IYABODE F AKINSANYA-BEYSOLOW M.D.,M.P.H.
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Gender | Female
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Dates
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Enumeration Date | 07/01/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3915 CASCADE RD SW PROMENADE PARK BUILDING,SUITE 310
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City | ATLANTA
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State | GA
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Zip | 30331-8512
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Country | US
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Telephone | 404-699-1339
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Fax | 404-699-1380
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Provider Business Mailing Address
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Address Line | 3305 HIDDEN TRAIL RD SE
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City | SMYRNA
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State | GA
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Zip | 30082-2442
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Country | US
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Telephone | 404-699-1339
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Fax | 404-699-1380
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 044618
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License Number State | GA
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