Provider Demographics
NPI:1407041445
Name:BYAKIKA, RICHARD LUBOGA (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LUBOGA
Last Name:BYAKIKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9875 HOSPITAL DR
Mailing Address - Street 2:SUITE 3009
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-4648
Mailing Address - Country:US
Mailing Address - Phone:763-581-1370
Mailing Address - Fax:763-581-1370
Practice Address - Street 1:9875 HOSPITAL DR
Practice Address - Street 2:SUITE 3009
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4648
Practice Address - Country:US
Practice Address - Phone:763-581-1370
Practice Address - Fax:763-581-1370
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200701540207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine