MEDICARE: DR. CHARLES OLUFEMI FOLASHADE 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	9700953	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

General Provider Information

NPI Number	:	1992764559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES OLUFEMI FOLASHADE M.D.

Provider Business Mailing Address
First Line	:	1805 MILTON RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-2437
Country	:	US
Telephone Number	:	704-535-1019
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 RHODES AVE
Second Line	:
City	:	WINDSOR
State	:	NC
Zip	:	27983-9656
Country	:	US
Telephone Number	:	252-794-3042
Fax Number	:	252-794-2911

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

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	02/27/2025

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