MEDICARE: DR. AKIYOMI O. FIELDS M.D.

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	207R00000X	Internal Medicine Physician	082040	GA

General Provider Information

NPI Number	:	1104118546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AKIYOMI O. FIELDS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 140444
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-0444
Country	:	US
Telephone Number	:	347-733-2677
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 GREENE AVE
Second Line	:	STE. LLB
City	:	BROOKLYN
State	:	NY
Zip	:	11238-6406
Country	:	US
Telephone Number	:	718-789-5900
Fax Number	:

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

Provider Enumeration Date	:	05/04/2011
Last Update Date	:	10/30/2019

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