Provider Demographics
NPI:1427008630
Name:MURAINA, OYEKUNLE ISMAIL (MD)
Entity Type:Individual
Prefix:DR
First Name:OYEKUNLE
Middle Name:ISMAIL
Last Name:MURAINA
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:PO BOX 24299
Mailing Address - Street 2:560 FIRST ST
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31212-4299
Mailing Address - Country:US
Mailing Address - Phone:478-744-9603
Mailing Address - Fax:478-744-9552
Practice Address - Street 1:560 FIRST ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201
Practice Address - Country:US
Practice Address - Phone:478-744-9603
Practice Address - Fax:478-744-9552
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044029207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00760515AMedicaid
GA11BDMVHMedicare PIN
G54538Medicare UPIN