Individual
AKHAGBOYE OLUFUNKE IDOWU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1203 MAPLE ST, GREENSBORO, NC 27405-6910
(336) 641-3754
Mailing address
1203 MAPLE ST, GREENSBORO, NC 27405-6910
(336) 641-3754
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
241644
NC
Other
Enumeration date
11/18/2014
Last updated
11/18/2014
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