Provider Demographics
NPI:1467867762
Name:AZUBUIKE, AKACHI (MD)
Entity Type:Individual
Prefix:
First Name:AKACHI
Middle Name:
Last Name:AZUBUIKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1096 S BELSAY RD
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48509-1948
Mailing Address - Country:US
Mailing Address - Phone:810-743-3351
Mailing Address - Fax:810-244-1239
Practice Address - Street 1:1096 S BELSAY RD
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509-1948
Practice Address - Country:US
Practice Address - Phone:810-743-3351
Practice Address - Fax:810-244-1239
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK01088607A208M00000X
IN01088607A208M00000X, 207Q00000X
MI4301106156207Q00000X
CAA168407207Q00000X
IL036156146207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIPENDINGMedicare PIN