MEDICARE: IFEDIORA FOSTER AFULUKWE 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	207RP1001X	Pulmonary Disease Physician	MD20627	SC
2	207R00000X	Internal Medicine Physician	MD20627	SC
3	207RS0012X	Sleep Medicine (Internal Medicine) Physician	20627	SC
4	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	20627	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417912932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IFEDIORA FOSTER AFULUKWE MD

Provider Business Mailing Address
First Line	:	PO BOX 49089
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-0073
Country	:	US
Telephone Number	:	803-273-4018
Fax Number	:	803-273-4023

Provider Business Practice Location Address
First Line	:	209 S COLLEGE ST
Second Line	:
City	:	HEATH SPRINGS
State	:	SC
Zip	:	29058-9710
Country	:	US
Telephone Number	:	803-273-4018
Fax Number	:	803-273-4023

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

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	12/21/2016

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