Provider Demographics
NPI:1922323484
Name:NINALOWO, HAMMED A (MD)
Entity Type:Individual
Prefix:
First Name:HAMMED
Middle Name:A
Last Name:NINALOWO
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 1:1162 WILDMEADOW RUN
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3034
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:DEPT OF RADIOLOGY
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-2007
Practice Address - Country:US
Practice Address - Phone:570-271-6301
Practice Address - Fax:570-271-5976
Is Sole Proprietor?:No
Enumeration Date:2010-03-28
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1505942085R0204X
390200000X
PAMD4561942085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program