Provider Demographics
NPI:1356334668
Name:AKINNUSI, MOROHUNFOLU EMMANUEL (MD)
Entity type:Individual
Prefix:
First Name:MOROHUNFOLU
Middle Name:EMMANUEL
Last Name:AKINNUSI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3600 ROUTE 66 FL 3
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-2645
Mailing Address - Country:US
Mailing Address - Phone:732-807-0877
Mailing Address - Fax:201-751-1680
Practice Address - Street 1:3750 PALLADIAN VILLAGE DR STE 110
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-8202
Practice Address - Country:US
Practice Address - Phone:678-878-2555
Practice Address - Fax:404-900-9055
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2024-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA11660700207RC0200X
GA064741207RP1001X, 207RS0012X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI11103Medicare UPIN