Provider Demographics
NPI:1306817184
Name:DOSUNMU-OGUNBI, ADEDOYIN B (MD)
Entity Type:Individual
Prefix:DR
First Name:ADEDOYIN
Middle Name:B
Last Name:DOSUNMU-OGUNBI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DOYIN
Other - Middle Name:
Other - Last Name:OGUNBI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:301 BROWN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7005
Mailing Address - Country:US
Mailing Address - Phone:334-747-4159
Mailing Address - Fax:334-747-4290
Practice Address - Street 1:2055 E SOUTH BLVD STE 202
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2002
Practice Address - Country:US
Practice Address - Phone:334-747-7575
Practice Address - Fax:334-747-7590
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15695207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529917550Medicaid
ALF00321Medicare UPIN
AL529917550Medicaid