Provider Demographics
NPI:1174843833
Name:IJAMAKINWA, NIHINLOLAWA OREOLUWA (MD)
Entity Type:Individual
Prefix:
First Name:NIHINLOLAWA
Middle Name:OREOLUWA
Last Name:IJAMAKINWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LOLA
Other - Middle Name:
Other - Last Name:ADEGUNLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2481 GEORGE BUSBEE PKWY NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-4961
Mailing Address - Country:US
Mailing Address - Phone:770-423-0000
Mailing Address - Fax:770-423-0131
Practice Address - Street 1:2481 GEORGE BUSBEE PKWY NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-4961
Practice Address - Country:US
Practice Address - Phone:770-423-0000
Practice Address - Fax:770-423-0131
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA69012207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine