Healthcare Provider Details

I. General information

NPI: 1245922509
Provider Name (Legal Business Name): ATINUKE ANJOOLA AMOO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date: 12/26/2023
Reactivation Date: 04/10/2024

III. Provider practice location address

N2198 CB7010
CHAPEL HILL NC
27599-7010
US

IV. Provider business mailing address

N2198 CB7010
CHAPEL HILL NC
27599-7010
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-4873
  • Fax:
Mailing address:
  • Phone: 919-966-4873
  • Fax: 919-966-5136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2026-02726
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: