Provider Demographics
NPI:1942456256
Name:ANAELE, CYRIACUS UZOMA (MD)
Entity Type:Individual
Prefix:DR
First Name:CYRIACUS
Middle Name:UZOMA
Last Name:ANAELE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CYRIACUS
Other - Middle Name:UZOMA
Other - Last Name:ANAELE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1008 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-5044
Mailing Address - Country:US
Mailing Address - Phone:573-472-7406
Mailing Address - Fax:573-472-7475
Practice Address - Street 1:601 PARK ST
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-1498
Practice Address - Country:US
Practice Address - Phone:570-253-8185
Practice Address - Fax:570-253-8348
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010031648207RN0300X, 208M00000X
PAMD479271207RN0300X, 207RN0300X
ARE-5694208M00000X, 208M00000X
LA313348207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB129093Medicare PIN