Provider Demographics
NPI:1932520095
Name:ANWUNAH, CHINYELU
Entity Type:Individual
Prefix:
First Name:CHINYELU
Middle Name:
Last Name:ANWUNAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20232 FARMINGTON RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1497
Mailing Address - Country:US
Mailing Address - Phone:248-987-1133
Mailing Address - Fax:
Practice Address - Street 1:20232 FARMINGTON RD
Practice Address - Street 2:SUITE A
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1497
Practice Address - Country:US
Practice Address - Phone:248-987-1133
Practice Address - Fax:248-987-1134
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker