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NPI Code Detail

MEDICARE: DR. GIDEON OKARI NYAKUNDI MD

MEDICARE: DR. GIDEON OKARI NYAKUNDI 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
1208000000XPediatrics Physician1134702079MI

General Provider Information

NPI Number : 1134702079
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GIDEON OKARI NYAKUNDI MD
Provider Business Mailing Address
First Line : 15125 22 MILE RD
Second Line :
City : SHELBY TOWNSHIP
State : MI
Zip : 48315-4406
Country : US
Telephone Number : 603-706-2916
Fax Number :
Provider Business Practice Location Address
First Line : 15125 22 MILE RD
Second Line :
City : SHELBY TOWNSHIP
State : MI
Zip : 48315-4406
Country : US
Telephone Number : 586-532-0599
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2021
Last Update Date : 12/02/2025

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