Provider Demographics
NPI:1245769843
Name:AKINBOYEWA, IBUKUN JULIA (MD)
Entity Type:Individual
Prefix:
First Name:IBUKUN
Middle Name:JULIA
Last Name:AKINBOYEWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 UNSER BLVD SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-3392
Mailing Address - Country:US
Mailing Address - Phone:505-253-1183
Mailing Address - Fax:270-253-1790
Practice Address - Street 1:2400 UNSER BLVD SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-3392
Practice Address - Country:US
Practice Address - Phone:505-253-1183
Practice Address - Fax:505-253-1790
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-07
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2020-0637207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine