Provider Demographics
NPI:1528255098
Name:OWUMI, WINIFRED (MD)
Entity type:Individual
Prefix:
First Name:WINIFRED
Middle Name:
Last Name:OWUMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:WINIFRED
Other - Middle Name:
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:230 BALDWIN AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3110
Mailing Address - Country:US
Mailing Address - Phone:704-376-5636
Mailing Address - Fax:704-376-5933
Practice Address - Street 1:230 BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3110
Practice Address - Country:US
Practice Address - Phone:704-376-5636
Practice Address - Fax:704-376-5933
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101246390200000X
NC2014-023862088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2014-02386OtherNC LICENSE