Sunday Imafidon
Nurse Practitioner, Family in Griffin, GA. Individual provider (NPI-1).
NPI number1801487293
StatusActive
Last updated in NPPESApr 26, 2021
Details
- NPI
- 1801487293
- Entity type
- Individual (NPI-1)
- Name
- Mr. Sunday Imafidon
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 29, 2021
- Certification date
- Apr 26, 2021
- Last updated
- Apr 26, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | RN230604 | GA | Yes |
Practice location
619 S 8th St Ste 301Griffin, GA 30224-4260
Phone 770-229-6072 · Fax 770-229-2111
Mailing address
619 S 8th St Ste 301Griffin, GA 30224-4260
Phone 770-229-6072
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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