Healthcare Provider Details

I. General information

NPI: 1144885591
Provider Name (Legal Business Name): UGOCHUKWU UZOCHUKWU OKAFOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2019
Last Update Date: 05/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6071 W OUTER DR FL 4
DETROIT MI
48235-2624
US

IV. Provider business mailing address

3400 NW 13TH ST
LAUDERHILL FL
33311-8327
US

V. Phone/Fax

Practice location:
  • Phone: 313-966-3250
  • Fax: 313-966-1738
Mailing address:
  • Phone: 305-748-3454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: