Provider Demographics
NPI:1811197064
Name:EKWUNIFE, SUNNY FELIX (DO)
Entity Type:Individual
Prefix:DR
First Name:SUNNY
Middle Name:FELIX
Last Name:EKWUNIFE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:FELIX
Other - Middle Name:SUNNY
Other - Last Name:EKWUNIFE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO,PHD
Mailing Address - Street 1:1733 PULASKI DR
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3677
Mailing Address - Country:US
Mailing Address - Phone:610-457-8952
Mailing Address - Fax:610-278-8608
Practice Address - Street 1:1733 PULASKI DR
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-3677
Practice Address - Country:US
Practice Address - Phone:610-457-8952
Practice Address - Fax:610-278-8608
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-010087-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH29872Medicare UPIN