Provider Demographics
NPI:1801852256
Name:MOROHUNFOLA, ADUNNI M (MD)
Entity Type:Individual
Prefix:
First Name:ADUNNI
Middle Name:M
Last Name:MOROHUNFOLA
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 1:6235 GRANBURY RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-3401
Mailing Address - Country:US
Mailing Address - Phone:817-546-1106
Mailing Address - Fax:817-263-8878
Practice Address - Street 1:3750 S UNIVERSITY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-3795
Practice Address - Country:US
Practice Address - Phone:817-546-1106
Practice Address - Fax:817-263-8878
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7057208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159787401Medicaid
TX159787401Medicaid