Provider Demographics
NPI:1720723299
Name:UBONG, ENO AKPAN (RPH)
Entity type:Individual
Prefix:MS
First Name:ENO
Middle Name:AKPAN
Last Name:UBONG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E 5TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-1641
Mailing Address - Country:US
Mailing Address - Phone:810-406-4246
Mailing Address - Fax:810-234-7068
Practice Address - Street 1:225 E 5TH ST STE 300
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502-1641
Practice Address - Country:US
Practice Address - Phone:810-406-4246
Practice Address - Fax:810-234-7068
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302030024183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist