Provider Demographics
NPI:1033378344
Name:OJO-CARONS, AKINWUNMI (MD)
Entity Type:Individual
Prefix:
First Name:AKINWUNMI
Middle Name:
Last Name:OJO-CARONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 CLEARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:VA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-1815
Mailing Address - Country:US
Mailing Address - Phone:757-457-5100
Mailing Address - Fax:757-961-3696
Practice Address - Street 1:7185 HARBOUR TOWNE PKWY S STE 200
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3796
Practice Address - Country:US
Practice Address - Phone:757-457-5100
Practice Address - Fax:757-961-3934
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101259893208800000X
MN58733208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAA180OtherGROUP MEDICARE NSC
VAVVL210A180OtherPROVIDER MEDICARE NSC