MEDICARE: DR. BABATUNDE OJO 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	174400000X	Specialist	9901274	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1246H	OTHER	NC	BCBS PROVIDER #

General Provider Information

NPI Number	:	1336125707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BABATUNDE OJO M.D.

Provider Business Mailing Address
First Line	:	1815 FORT BRAGG RD
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28303-6804
Country	:	US
Telephone Number	:	910-221-3301
Fax Number	:	910-221-3302

Provider Business Practice Location Address
First Line	:	1815 FORT BRAGG RD
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28303-6804
Country	:	US
Telephone Number	:	910-221-3301
Fax Number	:	910-221-3302

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

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	07/08/2011

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