Provider Demographics
NPI:1356306559
Name:ANAKWENZE, DAVID U (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:U
Last Name:ANAKWENZE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AGATHA
Other - Middle Name:
Other - Last Name:ANAKWENZE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:115 HELTON CT
Mailing Address - Street 2:B
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-1433
Mailing Address - Country:US
Mailing Address - Phone:256-767-4805
Mailing Address - Fax:256-767-4954
Practice Address - Street 1:115 HELTON CT
Practice Address - Street 2:B
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5313
Practice Address - Country:US
Practice Address - Phone:256-767-4805
Practice Address - Fax:256-767-4954
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL239082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529930240Medicaid
ALH26487Medicare UPIN