Provider Demographics
NPI:1316476658
Name:AKINLUA, GBADEBO SAMUEL (BUSINESS'S OWNER)
Entity type:Individual
Prefix:MR
First Name:GBADEBO
Middle Name:SAMUEL
Last Name:AKINLUA
Suffix:
Gender:M
Credentials:BUSINESS'S OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 THE EXCHANGE SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-7400
Mailing Address - Country:US
Mailing Address - Phone:309-550-2533
Mailing Address - Fax:
Practice Address - Street 1:1755 THE EXCHANGE SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-7400
Practice Address - Country:US
Practice Address - Phone:309-550-2533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies