Individual
DR. BONIFACE ATAKEKOR TUBIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20755 GREENFIELD RD, SUITE # 203, SOUTHFIELD, MI 48075-5403
(248) 395-2206
(248) 395-0456
Mailing address
20755 GREENFIELD RD, SUITE # 203, SOUTHFIELD, MI 48075-5403
(248) 395-2206
(248) 395-0456
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301072901
MI
207RN0300X
Nephrology Physician
Primary
4301072901
MI
246ZN0300X
Nephrology Specialist/Technologist
4301072901
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4341231
—
MI
Enumeration date
01/26/2007
Last updated
03/09/2022
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