Organization
MEDOGUN PA
Active
Other names
medogun psychiatric associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AYODELE ADETOKUNBO OGUNFOWORA M.D. (MEDICAL DIRECTOR)
(803) 788-7882
Entity
Organization
Contact information
Practice address
120 WILDEWOOD PARK DR, SUITE A, COLUMBIA, SC 29223-4300
(803) 788-7882
Mailing address
120 WILDEWOOD PARK DR, SUITE A, COLUMBIA, SC 29223-4300
(803) 788-7882
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
21075
SC
Other
Enumeration date
02/08/2007
Last updated
08/22/2020
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