Provider Demographics
NPI:1881222974
Name:AKANUMA, NAOKI (MD PHD)
Entity Type:Individual
Prefix:
First Name:NAOKI
Middle Name:
Last Name:AKANUMA
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 PINE ST APT 7
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02466-1330
Mailing Address - Country:US
Mailing Address - Phone:210-803-4492
Mailing Address - Fax:
Practice Address - Street 1:160 PINE ST APT 7
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:MA
Practice Address - Zip Code:02466-1330
Practice Address - Country:US
Practice Address - Phone:210-803-4492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program