MEDICARE: DR. OLANREWAJU YUSUF JIMOH MD, MBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program		TN
2	207RG0100X	Gastroenterology Physician	2018-00642	NC

General Provider Information

NPI Number	:	1053671586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OLANREWAJU YUSUF JIMOH MD, MBA

Provider Business Mailing Address
First Line	:	3426 TORINGDON WAY STE 108
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-3497
Country	:	US
Telephone Number	:	704-372-7974
Fax Number	:	704-970-4746

Provider Business Practice Location Address
First Line	:	300 BILLINGSLEY RD STE 200
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28211
Country	:	US
Telephone Number	:	704-372-7974
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2012
Last Update Date	:	01/13/2026

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