Provider Demographics
NPI:1033391693
Name:EGBUNIWE, AZUKA CASSANDRA (MD)
Entity Type:Individual
Prefix:MS
First Name:AZUKA
Middle Name:CASSANDRA
Last Name:EGBUNIWE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 291503
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37229-1503
Mailing Address - Country:US
Mailing Address - Phone:615-268-1186
Mailing Address - Fax:
Practice Address - Street 1:944 21ST AVE N
Practice Address - Street 2:APT# 706
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208-3400
Practice Address - Country:US
Practice Address - Phone:615-268-1186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301091247207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine