Healthcare Provider Details

I. General information

NPI: 1629162516
Provider Name (Legal Business Name): UKO EKAIKO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19111 WEST TEN MILE ROAD SUITE A8
SOUTHFIELD MI
48075
US

IV. Provider business mailing address

19111 WEST TEN MILE ROAD SUITE A8
SOUTHFIELD MI
48075
US

V. Phone/Fax

Practice location:
  • Phone: 248-356-7884
  • Fax: 248-356-1067
Mailing address:
  • Phone: 248-356-7884
  • Fax: 248-356-1067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number4458038
License Number StateMI

VIII. Authorized Official

Name: DR. UKO T EKAIKO
Title or Position: CONSULTANT
Credential: PH.D.
Phone: 248-356-7884