Provider Demographics
NPI:1952410110
Name:TOKUNBOH, JULIUS KEHINDE (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIUS
Middle Name:KEHINDE
Last Name:TOKUNBOH
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 1:2317 CONCORD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2813
Mailing Address - Country:US
Mailing Address - Phone:704-933-2101
Mailing Address - Fax:704-933-1150
Practice Address - Street 1:2317 CONCORD LAKE RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2813
Practice Address - Country:US
Practice Address - Phone:704-933-2101
Practice Address - Fax:704-933-1150
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9800405207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891148LMedicaid
NC891148LMedicaid
NCF77517Medicare UPIN