Healthcare Provider Details

I. General information

NPI: 1689837700
Provider Name (Legal Business Name): NURUDEEN SALIMONU LAWANI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

293 INDEPENDENCE BLVD
VIRGINIA BEACH VA
23462-5466
US

IV. Provider business mailing address

PO BOX 40412
BELFAST ME
04915-1255
US

V. Phone/Fax

Practice location:
  • Phone: 757-853-1380
  • Fax:
Mailing address:
  • Phone: 757-853-1380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0102202541
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0102202541
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102202541
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: