Healthcare Provider Details

I. General information

NPI: 1891438339
Provider Name (Legal Business Name): SIDNEY NNAMDI AKABOGU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 E SOUTH BLVD
MONTGOMERY AL
36116-2409
US

IV. Provider business mailing address

1142 22ND ST S APT 225
BIRMINGHAM AL
35205-2814
US

V. Phone/Fax

Practice location:
  • Phone: 334-288-2100
  • Fax:
Mailing address:
  • Phone: 210-833-4131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD.54099
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: