Provider Demographics
NPI:1114272457
Name:SHONUGA, OWOLABI ADEBAYO (MD)
Entity Type:Individual
Prefix:DR
First Name:OWOLABI
Middle Name:ADEBAYO
Last Name:SHONUGA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14605 POTOMAC BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3336
Mailing Address - Country:US
Mailing Address - Phone:703-490-1112
Mailing Address - Fax:703-878-8735
Practice Address - Street 1:14605 POTOMAC BRANCH DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191
Practice Address - Country:US
Practice Address - Phone:703-490-1112
Practice Address - Fax:703-878-8735
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101264693207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery