Individual
DR. ADEBUKOLA TAIWO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 ROBESON ST, SUITE 202, FAYETTEVILLE, NC 28301-5552
(910) 609-1630
(910) 609-1636
Mailing address
PO BOX 40908, FAYETTEVILLE, NC 28309-0908
(910) 609-6448
(910) 609-7040
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
0090-00454
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5902372
—
NC
Enumeration date
01/05/2006
Last updated
05/20/2013
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