Provider Demographics
NPI:1083809495
Name:BABALOLA, DOLAPO (MD)
Entity Type:Individual
Prefix:
First Name:DOLAPO
Middle Name:
Last Name:BABALOLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 JOHNSON FERRY PL STE A20
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-2053
Mailing Address - Country:US
Mailing Address - Phone:678-403-2199
Mailing Address - Fax:678-403-2275
Practice Address - Street 1:1230 JOHNSON FERRY PL STE A20
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-2053
Practice Address - Country:US
Practice Address - Phone:678-403-2199
Practice Address - Fax:678-403-2275
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA059119207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine