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Individual

AKINTAYO RAZAQ SOKUNBI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4201 CAMPUS RIDGE DRIVE, MIDLAND, MI 48640
(989) 488-5450
(989) 488-5455
Mailing address
4201 CAMPUS RIDGE DRIVE, MIDLAND, MI 48640
(989) 488-5450
(989) 488-5455

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301086213
MI
207RP1001X
Pulmonary Disease Physician
Primary
4301086213
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110F336360
BCBSM
MI
01
1346398971
GRP NPI
MI
01
205485614
TAX ID
MI
05
5359830
MI
01
AS086213
LICENSE
MI
Enumeration date
03/28/2008
Last updated
11/02/2016
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