Individual
DR. FULFILLED IWOSA IGHALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 713-4500
(336) 713-4501
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
2025-00948
NC
390200000X
Student in an Organized Health Care Education/Training Program
313269
LA
Other
Enumeration date
06/24/2019
Last updated
11/13/2025
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