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General NPI Number Information
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NPI Number | 1952695397
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Entity Type | Organization
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Legal Business Name | BENJAMIN O. AKIWUMI, MD
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Dates
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Enumeration Date | 06/02/2011
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Last Update Date | 03/14/2012
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Provider Practice Location Address
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Address Line | 105 W COURTHOUSE AVE
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City | BURGAW
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State | NC
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Zip | 28425-0000
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Country | US
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Telephone | 910-300-9220
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Fax | 910-300-9270
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Provider Business Mailing Address
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Address Line | PO BOX 1579
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City | BURGAW
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State | NC
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Zip | 28425-1579
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Country | US
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Telephone | 910-300-9220
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Fax | 910-300-9270
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | BENJAMIN OLUFEMI AKIWUMI
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Credential | M.D.
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Telephone | 910-300-9220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 9900005
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License Number State | NC
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