Bashiru A Dawodu, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

052162 Issued in GA

Practice address

35 S Scott St
Camilla, GA 31730-1705

Phone

(229) 336-9769

Fax

(229) 336-3867

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mitchell County Pediatrics Center

  • Pediatrics Physician
  • Camilla, GA
  • NPI 1932288271

  Pediatrics

  NPD (past) Authorized official
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 31, 2016.

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1093733305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 S SCOTT ST",
            "city": "CAMILLA",
            "state": "GA",
            "postal_code": "317301705",
            "telephone_number": "229-336-9769",
            "fax_number": "229-336-3867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 S SCOTT ST",
            "city": "CAMILLA",
            "state": "GA",
            "postal_code": "317301705",
            "telephone_number": "229-336-9769",
            "fax_number": "229-336-3867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWODU",
        "first_name": "BASHIRU",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "052162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00980526B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Corker
• Brett Daniel, PHARMD
• Alicia Davis
• Patricia Davis
• Sonji Marie Davis
• Vanessa L Dawson
• Dr Raymond J Otis Sr PC
• William Charles Dunn, PHARMD
• Tashema Durn
• Crystal Edmonds

• All providers in Camilla, GA
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.