Healthcare Provider Details

I. General information

NPI: 1154876522
Provider Name (Legal Business Name): ONYINYECHI A NWEKE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 04/12/2021
Certification Date: 04/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1522 JANES AVE
SAGINAW MI
48601-1819
US

IV. Provider business mailing address

1215 RAMSGATE RD APT 5
FLINT MI
48532-3153
US

V. Phone/Fax

Practice location:
  • Phone: 989-755-0316
  • Fax: 989-755-0956
Mailing address:
  • Phone: 248-635-0590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301500545
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: