Provider Demographics
NPI:1629054010
Name:WEATHERSBY, MARYJOY AKUNNA (MD)
Entity Type:Individual
Prefix:MS
First Name:MARYJOY
Middle Name:AKUNNA
Last Name:WEATHERSBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARYJOY
Other - Middle Name:AKUNNA
Other - Last Name:IHEANACHO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5920 SARATOGA BLVD #200
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78144
Mailing Address - Country:US
Mailing Address - Phone:361-994-5454
Mailing Address - Fax:361-994-5455
Practice Address - Street 1:5920 SARATOGA BLVD #200
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78144
Practice Address - Country:US
Practice Address - Phone:361-994-5454
Practice Address - Fax:361-994-5455
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ9170207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1077075Medicaid
TX1077075Medicaid
GA16BBCXGMedicare ID - Type Unspecified