Provider Demographics
NPI:1952377723
Name:AKINBILE, MUFUTAU (MD)
Entity Type:Individual
Prefix:DR
First Name:MUFUTAU
Middle Name:
Last Name:AKINBILE
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 1:6189 N PINNACLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-3502
Mailing Address - Country:US
Mailing Address - Phone:847-530-1350
Mailing Address - Fax:
Practice Address - Street 1:6189 N PINNACLE RIDGE DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-3502
Practice Address - Country:US
Practice Address - Phone:847-530-1350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL361052952080P0203X
AZ55425208D00000X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ690354Medicaid
ILK14690Medicaid
ILK14691Medicare ID - Type Unspecified