Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 0101259893 | VA |
NPI | 1033378344 |
---|---|
Provider Name | Akinwunmi Ojo-Carons |
First Address | Va Beach, VA 23462-1815 |
Second Address | Suffolk, VA 23435-3796 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 23/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A180 | GROUP MEDICARE NSC (01) | VA |
VVL210A180 | PROVIDER MEDICARE NSC (01) | VA |