Healthcare Provider Details

I. General information

NPI: 1730127127
Provider Name (Legal Business Name): ADORA C OKOGBULE-WONODI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 GEORGIA AVE NW FL 6
WASHINGTON DC
20060-1544
US

IV. Provider business mailing address

2041 GEORGIA AVE NW STE 3400
WASHINGTON DC
20060-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-865-4541
  • Fax: 202-865-7951
Mailing address:
  • Phone: 202-865-6679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberD61078
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD043691
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: