Provider Demographics
NPI:1528777489
Name:AKHIGBE, MICHAEL IZEBE
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:IZEBE
Last Name:AKHIGBE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:AKHIGBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6200 LOWRIDGE DR APT 304
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-9310
Mailing Address - Country:US
Mailing Address - Phone:614-592-1386
Mailing Address - Fax:
Practice Address - Street 1:6200 LOWRIDGE DR APT 304
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-9310
Practice Address - Country:US
Practice Address - Phone:614-592-1386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHUW714164376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty