Provider Demographics
NPI:1700916350
Name:NDUBUISI, ADANZE DOROTHY (PHARMD)
Entity Type:Individual
Prefix:
First Name:ADANZE
Middle Name:DOROTHY
Last Name:NDUBUISI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 TRAPPERS COVE TRL APT 2D
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-8205
Mailing Address - Country:US
Mailing Address - Phone:517-393-4228
Mailing Address - Fax:
Practice Address - Street 1:3825 W JOLLY RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-3362
Practice Address - Country:US
Practice Address - Phone:517-882-6616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302034046183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist