Dr. Reginald Eburuche, MD PLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301080385 Issued in MI

Legal business name

DR. REGINALD EBURUCHE, MD PLC

Practice address

23999 Northwestern Hwy
Suite 114
Southfield, MI 48075-2528

Phone

(248) 440-6090

Fax

(248) 440-6094

NPI assigned

Jan 9, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Patricia A Igwe

Title

Office Manager

Phone

(248) 440-6090

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Reginald N Eburuche Sr., MD

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1932189958
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649329913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23999 NORTHWESTERN HWY",
            "address_2": "SUITE 114",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752528",
            "telephone_number": "248-440-6090",
            "fax_number": "248-440-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23999 NORTHWESTERN HWY",
            "address_2": "SUITE 114",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752528",
            "telephone_number": "248-440-6090",
            "fax_number": "248-440-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. REGINALD EBURUCHE, MD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IGWE",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "248-440-6090",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301080385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4707732",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.