Individual
BEN O OGUNWALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
320 LILLINGTON AVE, SUITE 101, CHARLOTTE, NC 28204-3189
(704) 362-4403
(704) 362-4405
Mailing address
320 LILLINGTON AVE, SUITE 101, CHARLOTTE, NC 28204-3189
(704) 362-4403
(704) 362-4405
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35-082786
OH
207RG0100X
Gastroenterology Physician
Primary
2007-01133
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
59-12694
—
NC
Enumeration date
02/02/2007
Last updated
03/16/2017
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