Provider Demographics
NPI:1972650794
Name:OGUNNIYI, MODELE O (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MODELE
Middle Name:O
Last Name:OGUNNIYI
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 JESSE HILL JR DR
Mailing Address - Street 2:EMORY UNIV SOM, DIV OF CARDIOLOGY
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303
Mailing Address - Country:US
Mailing Address - Phone:404-616-4440
Mailing Address - Fax:404-616-4400
Practice Address - Street 1:80 JESSE HILL JR DR SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3050
Practice Address - Country:US
Practice Address - Phone:404-616-4440
Practice Address - Fax:404-616-4400
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA059841207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine