Provider Demographics
NPI:1396972733
Name:MKPARU, ANULI NWAIFE (MD, MBA, MSC)
Entity type:Individual
Prefix:DR
First Name:ANULI
Middle Name:NWAIFE
Last Name:MKPARU
Suffix:
Gender:F
Credentials:MD, MBA, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 E ALLEGHENY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-4433
Mailing Address - Country:US
Mailing Address - Phone:215-608-8937
Mailing Address - Fax:267-459-5831
Practice Address - Street 1:2340 E ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-4433
Practice Address - Country:US
Practice Address - Phone:215-608-8937
Practice Address - Fax:267-459-5831
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA00000207X00000X
NJ25MA10995200207X00000X
PAMD466348207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1396972733OtherINDIVIDUAL NPI