Individual
JOEL A ONAFOWOKAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3626 LATROBE DR, CHARLOTTE, NC 28211-1388
(704) 366-7182
(704) 366-7184
Mailing address
3626 LATROBE DR, CHARLOTTE, NC 28211-1388
(704) 366-7182
(704) 366-7184
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200401292
NC
207R00000X
Internal Medicine Physician
27357
SC
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
200401292
NC
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
61-2351
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1406K
BCBS
NC
05
—
5902366
—
NC
Enumeration date
03/25/2006
Last updated
08/03/2020
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