Individual
DR. MOBOLANLE O GBADAMOSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4761 WARD BLVD, WILSON, NC 27893-4359
(252) 399-2112
(252) 399-2132
Mailing address
4761 WARD BLVD, WILSON, NC 27893-4359
(252) 399-2112
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
200901445
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
157VR
BLUE CROSS BLUE SHIELD
NC
01
—
3131766
UNITED HEALTHCARE
NC
05
—
5913338
—
NC
Enumeration date
09/22/2009
Last updated
12/17/2020
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