Provider Demographics
NPI:1336839661
Name:AKUJUOBI, OBIANUJU MIRIAN (MD)
Entity Type:Individual
Prefix:
First Name:OBIANUJU
Middle Name:MIRIAN
Last Name:AKUJUOBI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OBIANUJU
Other - Middle Name:MIRIAN
Other - Last Name:OKOLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1425 PORTLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621
Mailing Address - Country:US
Mailing Address - Phone:585-922-4683
Mailing Address - Fax:585-922-4922
Practice Address - Street 1:1425 PORTLAND AVENUE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621
Practice Address - Country:US
Practice Address - Phone:585-922-4683
Practice Address - Fax:585-922-4922
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program