Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 4301089357 | MI |
N | 207VE0102X | Reproductive Endocrinologist | 4301089357 | MI |
NPI | 1437156064 |
---|---|
Provider Name | Dr. Awoniyi O Awonuga |
First Address | Troy, MI 48083-1189 |
Second Address | Southfield, MI 48034-1753 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2005 |
Last Update Date | 21/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02440260 | (05) | NY |
H96349 | (02) | NY |