Individual
ADEWUMI OLUSEGUN OGUNTUNMIBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
411 STEPHENSON AVE, SAVANNAH, GA 31405-5968
(912) 354-7679
(912) 354-4018
Mailing address
411 STEPHENSON AVE, SAVANNAH, GA 31405-5968
(912) 354-7679
(912) 354-4018
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
049393
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000900798I
—
GA
05
—
000900798M
—
GA
05
—
00900798C
—
GA
05
—
00900798D
—
GA
05
—
00900798E
—
GA
05
—
00900798F
—
GA
05
—
00900798G
—
GA
05
—
00900798H
—
GA
01
—
930105831
RAILROAD MEDICARE
GA
05
—
G49393
—
SC
01
—
N365366
WELLCARE OF GEORGIA
GA
Enumeration date
09/28/2006
Last updated
12/03/2013
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