Basic Information
| Provider Information | |||||||||
| NPI: | 1164845780 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADOFO | ||||||||
| FirstName: | MARGARET | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1331 MOUNT ZION RD | ||||||||
| Address2: | |||||||||
| City: | MORROW | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302602357 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7706293217 | ||||||||
| FaxNumber: | 7709684358 | ||||||||
| Practice Location | |||||||||
| Address1: | 1331 MOUNT ZION RD | ||||||||
| Address2: | |||||||||
| City: | MORROW | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302602357 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7706293217 | ||||||||
| FaxNumber: | 7709684358 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2014 | ||||||||
| LastUpdateDate: | 09/04/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN256346 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.