Organization
DR. REGINALD EBURUCHE, MD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA A IGWE (OFFICE MANAGER)
(248) 440-6090
Entity
Organization
Contact information
Practice address
23999 NORTHWESTERN HWY, SUITE 114, SOUTHFIELD, MI 48075-2528
(248) 440-6090
(248) 440-6094
Mailing address
23999 NORTHWESTERN HWY, SUITE 114, SOUTHFIELD, MI 48075-2528
(248) 440-6090
(248) 440-6094
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301080385
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4707732
—
MI
Enumeration date
01/09/2007
Last updated
08/22/2020
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