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General NPI Number Information
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NPI Number | 1750638169
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Entity Type | Individual
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Provider Name | JOSEPH ADESINA SOWUNMI
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Gender | Male
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Dates
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Enumeration Date | 08/06/2012
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Last Update Date | 08/28/2018
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Provider Practice Location Address
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Address Line | 1034 BRAGG ST
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City | RALEIGH
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State | NC
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Zip | 27610
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Country | US
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Telephone | 919-743-3601
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Fax |
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Provider Business Mailing Address
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Address Line | 5405 OPAL FALLS CIR
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City | RALEIGH
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State | NC
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Zip | 27616-5076
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Country | US
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Telephone | 919-740-0918
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5009228
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License Number State | NC
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