Individual
ADEWALE OGUNWO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1905 SKIBO RD, FAYETTEVILLE, NC 28314-0260
(910) 864-4357
(910) 221-0099
Mailing address
2732 BARDOLINO DR, FAYETTEVILLE, NC 28306-4636
(910) 868-6477
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
5005501
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NC5209A
PTAN
NC
Enumeration date
02/15/2012
Last updated
03/29/2012
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