Provider Demographics
NPI:1396796116
Name:AWONIYI, WILNELSIA A (DPM)
Entity type:Individual
Prefix:DR
First Name:WILNELSIA
Middle Name:A
Last Name:AWONIYI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:WILNELSIA
Other - Middle Name:A
Other - Last Name:AWONIYI-NORA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:56 HUGHES RD UNIT 1792
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-6573
Mailing Address - Country:US
Mailing Address - Phone:256-335-2778
Mailing Address - Fax:866-223-6822
Practice Address - Street 1:2009 WESTMEAD ST SW
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-4629
Practice Address - Country:US
Practice Address - Phone:256-323-1289
Practice Address - Fax:866-594-7549
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL290213E00000X
KY00307213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY800000607*50009167Medicaid
AL510I480010OtherMEDICARE
KY2019601OtherMEDICARE
AL510I480010OtherMEDICARE