Provider Demographics
NPI:1740625540
Name:AZIKEN, NKEM (MD)
Entity type:Individual
Prefix:MR
First Name:NKEM
Middle Name:
Last Name:AZIKEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 ARCH ST STE 407
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1433
Mailing Address - Country:US
Mailing Address - Phone:330-384-9001
Mailing Address - Fax:234-312-2342
Practice Address - Street 1:75 ARCH ST STE 407
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1433
Practice Address - Country:US
Practice Address - Phone:330-384-9001
Practice Address - Fax:234-312-2342
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.140330208600000X, 208G00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty