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NPI Code Detail

MEDICARE: DR. JOSEPHINE IRUKAEGO NGAMA MD

MEDICARE: DR. JOSEPHINE IRUKAEGO NGAMA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1023695632
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPHINE IRUKAEGO NGAMA MD
Provider Business Mailing Address
First Line : 3031 W GRAND BLVD STE 600
Second Line :
City : DETROIT
State : MI
Zip : 48202-3014
Country : US
Telephone Number : 313-871-3751
Fax Number :
Provider Business Practice Location Address
First Line : 3031 W GRAND BLVD STE 600
Second Line :
City : DETROIT
State : MI
Zip : 48202-3014
Country : US
Telephone Number : 313-871-3751
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2021
Last Update Date : 06/07/2026

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