Basic Information
Provider Information
NPI: 1588665616
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALUKO
FirstName: AKINYELE
MiddleName: O
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 60447
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282600447
CountryCode: US
TelephoneNumber: 7043439800
FaxNumber: 7043472011
Practice Location
Address1: 1718 E 4TH ST
Address2: STE 501
City: CHARLOTTE
State: NC
PostalCode: 282043260
CountryCode: US
TelephoneNumber: 7043439800
FaxNumber: 7043472011
Other Information
ProviderEnumerationDate: 08/10/2005
LastUpdateDate: 03/11/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X33606NCY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

ID Information
IDTypeStateIssuerDescription
891097805NC MEDICAID
N3360605SC MEDICAID


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