Basic Information
| Provider Information | |||||||||
| NPI: | 1902114424 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ONUOHA | ||||||||
| FirstName: | KENNETH | ||||||||
| MiddleName: | CHINEDU | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1601 E MICHIGAN AVE | ||||||||
| Address2: | STE 2 | ||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489122894 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5175803188 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1675 WATERTOWER PL | ||||||||
| Address2: | STE 700 | ||||||||
| City: | EAST LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488238047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5173948589 | ||||||||
| FaxNumber: | 5173948594 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2010 | ||||||||
| LastUpdateDate: | 03/27/2017 | ||||||||
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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 | 390200000X | MI | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 5101019040 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.