Organization
KINSTON INTERNAL MEDICINE & GERIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOBOLANLE O GBADAMOSI MD (PHYSICIAN)
(252) 208-1965
Entity
Organization
Contact information
Practice address
2508 N QUEEN ST, KINSTON, NC 28501-1631
(252) 208-1965
(252) 208-1962
Mailing address
2508 N QUEEN ST, KINSTON, NC 28501-1631
(252) 208-1965
(252) 208-1962
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
200901445
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5913338
—
NC
01
—
A936
PALMETTO/GBA
NC
Enumeration date
04/11/2012
Last updated
07/16/2013
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