OrganizationActive
Graceful Aging,pc
NPI 1316259013 · Geriatric Medicine (Family Medicine) Physician · Fayetteville, NC
Provider details
- NPI number
- 1316259013
- Entity type
- Organization
- Primary specialty
- Geriatric Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Susannah Ogunwo, President
- License
- 200601059 (NC)
Mailing address
Po Box 87142
Fayetteville, NC 28304-7142
Registry dates
- Enumerated
- 2010-07-09
- Last updated
- 2010-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.