Basic Information
| Provider Information | |||||||||
| NPI: | 1063737831 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OBI | ||||||||
| FirstName: | CHIKE | ||||||||
| MiddleName: | UCHENNA ANTHONY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2799 W GRAND BLVD | ||||||||
| Address2: | HENRY FORD HOSPITAL | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482022608 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 3300 OAKDALE AVE N | ||||||||
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| City: | ROBBINSDALE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554222926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7635815400 | ||||||||
| FaxNumber: | 7635815401 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2010 | ||||||||
| LastUpdateDate: | 12/31/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD447986 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 125 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | 4301104529 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RA0001X | 62720 | MN | Y |
No ID Information.