Individual
TETE ONIANGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4241 MAPLE ST, DEARBORN, MI 48126-3826
(313) 646-8157
Mailing address
788 WINESAP, ROCHESTER HILLS, MI 48307-6807
(646) 342-7388
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301091134
MI
208D00000X
General Practice Physician
Primary
4301091134
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
270367580
TAX ID #
MI
Enumeration date
10/21/2007
Last updated
04/02/2012
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