Individual
GORJI ETAPONAOBASE EKWESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
HENRY FORD HOSPITAL, 2799 W. GRAND BLVD, DETROIT, MI 48202
(313) 916-0010
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 874-4806
(313) 876-1305
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
4704264505
MI
363LP2300X
Primary Care Nurse Practitioner
Primary
4704264505
MI
Other
Enumeration date
08/28/2016
Last updated
12/01/2022
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