MARY BOLUWATIFE IDOWU (NPI# 1235664376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235664376 |
| Entity Type | Individual |
| Full Name | MARY BOLUWATIFE IDOWU |
| Credential | M.D. |
| Practice Address |
937 Atlantic Ave Virginia Beach VA 23451-3529 |
| Practice Telephone | 7575109516 |
| Mailing Telephone | 7575109516 |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2020-09-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 0101265340 | VA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Ob Gyn Walter Reed National Military Ctr, 8901 Wisconsin Avenue, Bethesda, MD 208890001 | 3012952045 |
| Street Address |
937 ATLANTIC AVE |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23451-3529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154866887 | Jessica Leigh Zimmerman | General Practice | 937 Atlantic Ave, Virginia Beach, VA 23451-3529 | 2017-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316547268 | Brynn Arica Carey | Speech-Language Pathologist | Laskin Road Annex, 1413 Laskin Road, Virginia Beach, VA 23451 | 2020-10-29 |
| 1851864094 | Erica Genevieve Johns | Counselor | 253 C Street, Camp Pendleton, Virginia Beach, VA 23451 | 2019-01-10 |
| 1407327729 | Crystal Michelle Larios | Physical Therapy Assistant | Westminster Canterbury, Virginia Beach, VA 23451 | 2018-12-14 |
| 1215423322 | Ketan Patel | Dentist | 395 Norfolk Ave, Virginia Beach, VA 23451 | 2018-07-02 |
| 1356844427 | Kristina Maria Matthews | Nurse's Aide | 1206 Laskin Road, Suite 140-g, Virginia Beach, VA 23451 | 2018-03-14 |
| 1437652823 | Beach Medical Suppliers LLC | Durable Medical Equipment & Medical Supplies | 2256 W. Great Neck Rd, Virginia Beach, VA 23451 | 2018-03-13 |
| 1740782291 | Sherree Weeks | Speech-Language Pathologist | 1413 Laskin Rd., Va. Beach, VA 23451 | 2018-03-01 |
| 1649709007 | Christine Herslow | Registered Nurse | 2200 Elder Road, Virginia Beach, VA 23451 | 2017-06-08 |
| 1538611066 | Wal-mart Stores East, Lp | Technician/Technologist | 546 First Colonial Road, Virginia Beach, VA 23451 | 2016-11-01 |
| 1306182795 | John Leroy Stacy Jr. | Counselor | 409 Birdneck Cir, Virginia Beach, VA 23451 | 2012-12-12 |
| Find all providers in zip 23451 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346742582 | Adam Fehringer | General Practice | 1035 Nider Blvd # 100, Virginia Beach, VA 23459-8701 | 2018-03-04 |
| 1619400249 | Michael Alexander Sumner | General Practice | Nas Oceana Branch Medical Clinic, 1640 Tomcat Blvd, Virginia Beach, VA 23460 | 2017-04-10 |
| 1154866887 | Jessica Leigh Zimmerman | General Practice | 937 Atlantic Ave, Virginia Beach, VA 23451-3529 | 2017-01-04 |
| 1588935829 | Heather Sterling Slusser | General Practice | 1750 Tomcat Blvd, Branch Medical Clinic Oceana, Virginia Beach, VA 23460-2168 | 2012-01-18 |
| 1124251491 | Beachtown Health Care Pllc | General Practice | 3750 Chesterfield Ave, Virginia Beach, VA 23455-2940 | 2009-09-02 |
| 1417089244 | Douglas Dewey Conkwright Jr. | General Practice | 527 N Great Neck Rd, Virginia Beach, VA 23454 | 2007-03-09 |
| 1538270756 | Jennifer F Krup | General Practice | 1020 Independance Blvd, Suite 101, Virginia Beach, VA 23455 | 2006-08-31 |
| 1720049174 | Ramon E Baez Jr. | General Practice | 5064 Finn Rd, Virginia Beach, VA 23455-2642 | 2006-03-28 |
| 1912983768 | Paul David Johnstone | General Practice | 3100 Shore Dr, Virginia Beach, VA 23451-1199 | 2005-12-22 |
| 1982680880 | Florisa Sabiniano Singson | General Practice | 4551 Professional Cir Ste 201, Virginia Beach, VA 23455-6442 | 2005-12-21 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23451 |
Please comment or provide details below to improve the information on MARY BOLUWATIFE IDOWU.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.