Provider Demographics
NPI:1770731713
Name:AKINNUSI, OPEOLUWA OLABISI (MD)
Entity type:Individual
Prefix:MRS
First Name:OPEOLUWA
Middle Name:OLABISI
Last Name:AKINNUSI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OPEOLUWA
Other - Middle Name:OLABISI
Other - Last Name:NUBI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3750 PALLADIAN VILLAGE DR STE 110&120
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-8200
Mailing Address - Country:US
Mailing Address - Phone:678-218-9586
Mailing Address - Fax:678-265-8362
Practice Address - Street 1:3750 PALLADIAN VILLAGE DR STE 110&120
Practice Address - Street 2:
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:678-265-8362
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2461052084P0804X
GA648022084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty