Provider Demographics
NPI:1780629519
Name:AWUJO, AKINWOLE A (MD)
Entity Type:Individual
Prefix:DR
First Name:AKINWOLE
Middle Name:A
Last Name:AWUJO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:34 UPPER RIVERDALE RD SE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-2635
Mailing Address - Country:US
Mailing Address - Phone:770-996-0622
Mailing Address - Fax:770-996-1492
Practice Address - Street 1:34 UPPER RIVERDALE RD SE
Practice Address - Street 2:SUITE 200
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2635
Practice Address - Country:US
Practice Address - Phone:770-996-0622
Practice Address - Fax:770-996-1492
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA048204207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA93BFCWSMedicare ID - Type Unspecified
GAGRP6884Medicare PIN
GAG54662Medicare UPIN