Healthcare Provider Details

I. General information

NPI: 1497102677
Provider Name (Legal Business Name): CHUMA OKOYE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2016
Last Update Date: 05/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26039 BERG RD
SOUTHFIELD MI
48033-2419
US

IV. Provider business mailing address

26039 BERG RD
SOUTHFIELD MI
48033-2419
US

V. Phone/Fax

Practice location:
  • Phone: 248-796-1501
  • Fax:
Mailing address:
  • Phone: 248-796-1501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: