Sobanjo, Elizabeth Imade
Sobanjo, Elizabeth Imade is an individual health care provider with primary practice located at 1525 E Park Place Blvd Suite 1800, Stone Mountain GA 30087-3453. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Sobanjo, Elizabeth Imade can be contacted via phone (770) 498-3434.Contact Information
Primary practice address
1525 E Park Place Blvd Suite 1800
Stone Mountain GA 30087-3453
Phone: (770) 498-3434
Fax: (770) 498-3440
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1538 | Georgia |
Profile Details
| NPI number | 1548313851 |
|---|---|
| LBN Legal business name | Sobanjo, Elizabeth Imade |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 19th, 2007 |
| Last updated | Apr 26th, 2016 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548313851 | NPPES |
| Georgia | MEDICAID | 000900413A |
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