NPI age
19 years
Enumerated 2006-10-23
● Active
Type 1 · Individual
DR. Olaniyi Olabode Osofisan, M.D.
Osofisan is 1 of 9 internal medicine providers in Braselton and 1 of 952 in Georgia.
Primary specialty
Internal Medicine
Plus 1 subspecialty
Licensed in
GA, MT
2 states
Status
Active
No deactivations on record
Last NPPES update
2025-04-09
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 952 active internal medicine providers in Georgia.
NPI age
19 years
≈ at median (19 yr)
State licenses
2 states
Top 82% — 17% of peers are multi-state
Subspecialties
0
40% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-10Enumerated in NPPES
2006
2026
Where they practice
Practice location
1404 River Pl Ste 501
Braselton, GA 305175600
Mailing address
Po Box 742616
Atlanta, GA 303742616
Additional practice locations
2 secondary locations on file with NPPES.
Location 2
3459 Acworth Due West Rd Nw, Suite 559
Acworth, GA 301015819
Location 3
937 Highland Blvd
Bozeman, MT 597156909
Specialties
-
Internal Medicine PrimaryAn internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 173191749A |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 20 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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