Provider Demographics
NPI:1477509404
Name:AYIKU, HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:
Last Name:AYIKU
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 1:1481 TOBIAS GADSON BLVD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4794
Mailing Address - Country:US
Mailing Address - Phone:843-766-5633
Mailing Address - Fax:843-766-5634
Practice Address - Street 1:3815 FABER PLACE DR
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-8533
Practice Address - Country:US
Practice Address - Phone:843-767-9312
Practice Address - Fax:843-767-9313
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23994208M00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00867380OtherRAILROAD MEDICARE ID-RSFPN
SC239940Medicaid
SCH687859223Medicare PIN