Provider Demographics
NPI:1558199182
Name:OBI, OBIANUJU AFOMA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:OBIANUJU
Middle Name:AFOMA
Last Name:OBI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9009 MAGNOLIA LILY AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-4644
Mailing Address - Country:US
Mailing Address - Phone:704-713-7241
Mailing Address - Fax:
Practice Address - Street 1:6231 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3262
Practice Address - Country:US
Practice Address - Phone:704-553-1078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33285183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist