Provider Demographics
NPI:1225603681
Name:EKPUNOBI, NZUBE (MD)
Entity type:Individual
Prefix:
First Name:NZUBE
Middle Name:
Last Name:EKPUNOBI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:752 N HIGH POINT RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-2236
Mailing Address - Country:US
Mailing Address - Phone:608-824-4000
Mailing Address - Fax:608-824-4104
Practice Address - Street 1:752 N HIGH POINT RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-2236
Practice Address - Country:US
Practice Address - Phone:608-824-4000
Practice Address - Fax:608-824-4104
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2024-11-22
Deactivation Date:2022-11-25
Deactivation Code:
Reactivation Date:2023-01-30
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI4351048640390200000X
WI84243-20207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1225603681Medicaid
MI4351048640OtherMI STATE MED LICENSE