MEDICARE: MOROHUNFOLU EMMANUEL AKINNUSI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	25MA11660700	NJ
2	207RP1001X	Pulmonary Disease Physician	064741	GA
3	207RS0012X	Sleep Medicine (Internal Medicine) Physician	064741	GA
4	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	064741	GA

General Provider Information

NPI Number	:	1356334668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOROHUNFOLU EMMANUEL AKINNUSI MD

Provider Business Mailing Address
First Line	:	3600 ROUTE 66 FL 3
Second Line	:
City	:	NEPTUNE
State	:	NJ
Zip	:	07753-2645
Country	:	US
Telephone Number	:	732-807-0877
Fax Number	:	201-751-1680

Provider Business Practice Location Address
First Line	:	3750 PALLADIAN VILLAGE DR STE 110
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-8202
Country	:	US
Telephone Number	:	678-878-2555
Fax Number	:	404-900-9055

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	03/20/2024

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