Basic Information
| Provider Information | |||||||||
| NPI: | 1942456256 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ANAELE | ||||||||
| FirstName: | UZOMA | ||||||||
| MiddleName: | CYRIACUS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ANAELE | ||||||||
| OtherFirstName: | CYRIACUS | ||||||||
| OtherMiddleName: | UZOMA | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1008 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | SIKESTON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 638015044 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5734727406 | ||||||||
| FaxNumber: | 5734727475 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 PARK ST | ||||||||
| Address2: | |||||||||
| City: | HONESDALE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 184311498 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702538185 | ||||||||
| FaxNumber: | 5702538348 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2008 | ||||||||
| LastUpdateDate: | 10/31/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 10/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D067185 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | N7207 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 208M00000X | 2010031648 | MO | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | E-5694 | AR | N | Allopathic & Osteopathic Physicians | Hospitalist | 207RN0300X | MD479271 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.