Provider Demographics
NPI:1144232620
Name:NWANKWO, FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:
Last Name:NWANKWO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:FRANCIS
Other - Middle Name:
Other - Last Name:NWANKWO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2267
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48106-2267
Mailing Address - Country:US
Mailing Address - Phone:734-747-7551
Mailing Address - Fax:
Practice Address - Street 1:2515 PACKARD ST
Practice Address - Street 2:SUITE G
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-6806
Practice Address - Country:US
Practice Address - Phone:734-747-7551
Practice Address - Fax:866-874-3226
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301406564207Q00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4497949Medicaid
MI4497949Medicaid
MIP20580001Medicare ID - Type Unspecified