Elosiebo-Walker, Raven Ifoma

Elosiebo-Walker, Raven Ifoma is an individual health care provider with primary practice located at 1462 Montreal Rd Ste 411 , Tucker GA 30084-6932. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Elosiebo-Walker, Raven Ifoma can be contacted via phone (404) 296-8000.

Contact Information

Primary practice address
1462 Montreal Rd Ste 411 Tucker GA 30084-6932
Phone: (404) 296-8000
Fax: (770) 493-6842
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 74090 Georgia

Profile Details

NPI number 1437441797
LBN Legal business name Elosiebo-Walker, Raven Ifoma
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2011
Last updated Nov 9th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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