Provider Demographics
NPI:1689057986
Name:SLEEP AND LUNG SPECIALISTS, LLC
Entity Type:Organization
Organization Name:SLEEP AND LUNG SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MOROHUNFOLU
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINNUSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-218-8359
Mailing Address - Street 1:3750 PALLADIAN VILLAGE DR
Mailing Address - Street 2:STE. 100
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-8200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3750 PALLADIAN VILLAGE DR
Practice Address - Street 2:SUITE 110
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-8200
Practice Address - Country:US
Practice Address - Phone:678-265-8361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-04
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA64741207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I294256Medicare PIN