Provider Demographics
NPI:1083868954
Name:EGBUNIKE, CHRISTOPHER NONSO JR (CNIM)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:NONSO
Last Name:EGBUNIKE
Suffix:JR
Gender:M
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2926 W GRANADA RD APT 2
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85009-2572
Mailing Address - Country:US
Mailing Address - Phone:480-717-2711
Mailing Address - Fax:
Practice Address - Street 1:2926 W GRANADA RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85009-2572
Practice Address - Country:US
Practice Address - Phone:480-717-2711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic