Organization
BONIFACE A. TUBIE, M.D.
Active
Other names
Delta Renal Group, P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BONIFACE ATAKEKOR TUBIE M.D. (PHYSICIAN/ CEO)
(248) 395-2206
Entity
Organization
Contact information
Practice address
20755 GREENFIELD RD, SUITE #203, SOUTHFIELD, MI 48075-5403
(248) 395-2206
(248) 395-0456
Mailing address
6915 DOBBS WAY, WEST BLOOMFIELD, MI 48322-3077
(248) 592-1518
(248) 395-0456
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301072901
MI
207RN0300X
Nephrology Physician
43010729901
MI
246ZN0300X
Nephrology Specialist/Technologist
4301072901
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4341231
—
MI
Enumeration date
09/08/2006
Last updated
09/11/2025
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