Provider Demographics
NPI:1518067255
Name:MOMODU, INUA (MD)
Entity type:Individual
Prefix:
First Name:INUA
Middle Name:
Last Name:MOMODU
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 1:111 NEW BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-6999
Mailing Address - Country:US
Mailing Address - Phone:609-402-5010
Mailing Address - Fax:888-487-0032
Practice Address - Street 1:2021 NEW RD STE 15
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1045
Practice Address - Country:US
Practice Address - Phone:609-596-2360
Practice Address - Fax:888-487-0032
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA075314002084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0036846Medicaid
NJ082354CB9Medicare PIN
H71107Medicare UPIN
082354CB8Medicare ID - Type Unspecified