Provider Demographics
NPI:1154775914
Name:TAIWO, MUINAT ATINUKE (MD)
Entity type:Individual
Prefix:
First Name:MUINAT
Middle Name:ATINUKE
Last Name:TAIWO
Suffix:
Gender:F
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:TRISTAR HORIZON MEDICAL CENTER
Mailing Address - Street 2:111 HIGHWAY 70 EAST
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055
Mailing Address - Country:US
Mailing Address - Phone:615-446-0446
Mailing Address - Fax:
Practice Address - Street 1:TRISTAR HORIZON MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055
Practice Address - Country:US
Practice Address - Phone:615-446-0446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN390207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine