Provider Demographics
NPI:1144941642
Name:AZUBIKE, ANTHONIA IFEOMA
Entity type:Individual
Prefix:
First Name:ANTHONIA
Middle Name:IFEOMA
Last Name:AZUBIKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANTHONIA
Other - Middle Name:IFEOMA
Other - Last Name:AGULONU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 CLOVERDALE DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-2700
Mailing Address - Country:US
Mailing Address - Phone:301-675-6920
Mailing Address - Fax:
Practice Address - Street 1:8210 RENAISSANCE PKWY
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6688
Practice Address - Country:US
Practice Address - Phone:919-425-0002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31542183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist