Organization
DELTA RENAL GROUP, P.C.
Active
Other names
Boniface Tubie, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BONIFACE ATAKEKOR TUBIE M.D. (PRESIDENT/ COE)
(248) 395-2206
Entity
Organization
Contact information
Practice address
20755 GREENFIELD RD, SUITE NUMBER 203, SOUTHFIELD, MI 48075-5403
(248) 395-2206
(248) 395-0456
Mailing address
20755 GREENFIELD RD, SUITE NUMBER 203, SOUTHFIELD, MI 48075-5403
(248) 395-2206
(248) 395-0456
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
4301072901
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4341231
—
MI
Enumeration date
08/02/2006
Last updated
08/22/2020
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