Provider Demographics
NPI:1720059397
Name:EFOBI, DEKA ACHUFUSI (MD)
Entity Type:Individual
Prefix:DR
First Name:DEKA
Middle Name:ACHUFUSI
Last Name:EFOBI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 414
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37024-0414
Mailing Address - Country:US
Mailing Address - Phone:615-809-2433
Mailing Address - Fax:615-443-9978
Practice Address - Street 1:1029 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-2450
Practice Address - Country:US
Practice Address - Phone:615-809-2433
Practice Address - Fax:615-443-9978
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN405242084N0400X
INCV22005262084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH57098Medicare UPIN