Enoch Oluwalonimi Adewara, MD

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Aiken, SC

NPI 1700629573 · NPPES record last updated Jun 18, 2024

Key facts

NPI
1700629573
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
302 University Pkwy
Aiken, SC 29801-6302
Phone
(803) 641-5275
NPI assigned
Jun 18, 2024
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240930004055 SC Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
6305377409

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

302 University Pkwy
Aiken, SC 29801-6302

Mailing address

302 University Pkwy
Aiken, SC 29801-6302
Phone (803) 641-5275

Other providers in Aiken, SC

All providers in Aiken, SC · Student in an Organized Health Care Education/Training Program in South Carolina

Sources for this page

Verify at the official NPI Registry.