Provider Demographics
NPI:1376053173
Name:AJULUFOH, BARTHOLOMEW OGBNONNIA
Entity Type:Individual
Prefix:
First Name:BARTHOLOMEW
Middle Name:OGBNONNIA
Last Name:AJULUFOH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23580 ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-3700
Mailing Address - Country:US
Mailing Address - Phone:248-514-9517
Mailing Address - Fax:
Practice Address - Street 1:23580 ONEIDA ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-3700
Practice Address - Country:US
Practice Address - Phone:248-514-9517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide