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Mobolaji Babatope Bakare

Internal Medicine

Allopathic & Osteopathic Physicians

3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013

PECOS Enrollment

This provider is enrolled in PECOS as MOBOLAJI BAKARE.

Based on the most recent information from CMS, provider Mobolaji Babatope Bakare is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1437106887
Provider Type
Individual
Full Name
Bakare, Mobolaji Babatope
Title
Dr.

Gender
Male
Sole Proprietor
No
Enumeration Date
5/30/2006
Last Updated
2/22/2024

Contact Information

Practice Location

3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013

(336) 718-8383

(336) 718-9622

Mailing Location

PO Box 60447, Charlotte, NC 28260-0447

(336) 718-8383

(336) 718-9622

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 2005-01273 North Carolina
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License 2005-01273 North Carolina

Provider Identifiers

ID	Description	Issuer
ID 7453359	Description Other	Issuer AETNA North Carolina

Mobolaji Babatope Bakare

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Novant Health Medical Group, Llc

Hernandez, Hermes Xavier

Manam, Rupesh

Li, Na

Tonos, Anthony

Murphy, Nancy L

Austria, Eric Jovan

Galbreath, John W

Marx, Richard S

Manickam, Panneer Selvan