Provider Demographics
NPI:1992314967
Name:ANUFORO, ANDERSON CHINAEDUM (MD)
Entity type:Individual
Prefix:DR
First Name:ANDERSON
Middle Name:CHINAEDUM
Last Name:ANUFORO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ANDERSON
Other - Middle Name:CHIDI
Other - Last Name:ANUFORO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:750 E ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1834
Mailing Address - Country:US
Mailing Address - Phone:315-464-5240
Mailing Address - Fax:315-464-3751
Practice Address - Street 1:750 E ADAMS ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2306
Practice Address - Country:US
Practice Address - Phone:315-464-5240
Practice Address - Fax:315-464-3751
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program