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Individual

DR. OLUWATOYIN FATAI BAMGBOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-5720
(336) 713-4500
(336) 713-4501
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 713-4500
(336) 713-4501

Taxonomy

Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
2025-01388
NC
2080P0210X
Pediatric Nephrology Physician
220028
NY
2080P0210X
Pediatric Nephrology Physician
23259
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06572063
MS
05
1025704
LA
Enumeration date
03/09/2006
Last updated
07/31/2025
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