Provider Demographics
NPI:1578917811
Name:AWOYODE, SUSANNA (MD, MHS)
Entity Type:Individual
Prefix:
First Name:SUSANNA
Middle Name:
Last Name:AWOYODE
Suffix:
Gender:F
Credentials:MD, MHS
Other - Prefix:
Other - First Name:SUSANNA
Other - Middle Name:
Other - Last Name:ADEBOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2004 HAYES ST STE 800
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2659
Mailing Address - Country:US
Mailing Address - Phone:615-329-0570
Mailing Address - Fax:615-329-0579
Practice Address - Street 1:776 WEATHERLY DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-8921
Practice Address - Country:US
Practice Address - Phone:931-906-2004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-22
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN59918207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine