Provider Demographics
NPI:1629429469
Name:AJUONUMA, FELIX OKECHUKWU (DO)
Entity Type:Individual
Prefix:DR
First Name:FELIX
Middle Name:OKECHUKWU
Last Name:AJUONUMA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 GLENVILLE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-3946
Mailing Address - Country:US
Mailing Address - Phone:734-417-9235
Mailing Address - Fax:
Practice Address - Street 1:708 GLENVILLE LAKE DR
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-3946
Practice Address - Country:US
Practice Address - Phone:734-417-9235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC2019-00592207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program