MEDICARE: ADUNNI M. MOROHUNFOLA 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	208000000X	Pediatrics Physician	L7057	TX

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

General Provider Information

NPI Number	:	1801852256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADUNNI M. MOROHUNFOLA M.D.

Provider Business Mailing Address
First Line	:	6235 GRANBURY RD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-3401
Country	:	US
Telephone Number	:	817-546-1106
Fax Number	:	817-263-8878

Provider Business Practice Location Address
First Line	:	3750 S UNIVERSITY DR
Second Line	:	SUITE 200
City	:	FORT WORTH
State	:	TX
Zip	:	76109-3795
Country	:	US
Telephone Number	:	817-546-1106
Fax Number	:	817-263-8878

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

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	05/28/2009

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