Provider Demographics
NPI:1548987084
Name:SONUBI, ADEBANJO O (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ADEBANJO
Middle Name:O
Last Name:SONUBI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1464 LYNCHBURG PL
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-2063
Mailing Address - Country:US
Mailing Address - Phone:404-434-0337
Mailing Address - Fax:
Practice Address - Street 1:1464 LYNCHBURG PL
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-2063
Practice Address - Country:US
Practice Address - Phone:404-434-0337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-25
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0143151835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist