Provider Demographics
NPI:1275893703
Name:MMONU, NNENAYA AGOCHUKWU (MD)
Entity Type:Individual
Prefix:DR
First Name:NNENAYA
Middle Name:AGOCHUKWU
Last Name:MMONU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NNENAYA
Other - Middle Name:QUEEN
Other - Last Name:AGOCHUKWU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3621 S STATE ST
Mailing Address - Street 2:700 KMS PLACE
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108
Mailing Address - Country:US
Mailing Address - Phone:734-936-2047
Mailing Address - Fax:
Practice Address - Street 1:1500 E MEDICAL CENTER DR
Practice Address - Street 2:2ND FLOOR TAUBMAN CENTER RECP C
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5330
Practice Address - Country:US
Practice Address - Phone:734-936-7030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-17
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI4301113343208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program