Ibukunoluwa Fakunle, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

4351045160 Issued in MI

Practice address

1 Hurley PLZ
Flint, MI 48503-5902

Phone

(810) 262-9000

NPI assigned

Aug 12, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1346896883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902",
            "telephone_number": "810-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902",
            "telephone_number": "810-262-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKUNLE",
        "first_name": "IBUKUNOLUWA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351045160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Marie Fadeley, LLMSW
• Hytham Hassan Mohamed Fadl, M.D.
• Joyce Renick Fahrner, MD
• Donna Lynn Fair, LLMSW
• Raijon Fair
• Brian F Falk, DC
• Vaibhavkumar Bharatbhai Falki, MD
• Emily Hunter Falvey, PRC
• Family Dental Group Associates PLLC
• Family Orthopedic Associates P L C

• All providers in Flint, MI
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.