Physician Compare National (NPI:1649409301)

HEALTHCARE PROVIDER: EFEMWONKIEKIE IYAMU MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1649409301
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9830345248
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170313000576
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	IYAMU
	Individual professional last name
Provider First Name	EFEMWONKIEKIE
	Individual professional first name
Provider Middle Name	WILLIAMS
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	HOSPITALIST
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	3719 LATROBE DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 840
	Group Practice or individual's line 2 address
City	CHARLOTTE
	Group Practice or individual's city
State	NC
	Group Practice or individual's state
Zip Code	282115121
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	340013
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	RUTHERFORD REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	340001
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CAROLINAS MEDICAL CENTER-NORTHEAST
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y