Basic Information
| Provider Information | |||||||||
| NPI: | 1669541512 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OGUNFUWA | ||||||||
| FirstName: | ADEKUNLE | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 E MCBEE AVE STE 401 | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296012842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8645228603 | ||||||||
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| Practice Location | |||||||||
| Address1: | 701 GROVE RD FL 5 | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296054210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8644554411 | ||||||||
| FaxNumber: | 8644554480 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2006 | ||||||||
| LastUpdateDate: | 09/20/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME90143 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 34296 | SC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 054827 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | ME90143 | FL | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 34296 | SC | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.