Provider Demographics
NPI:1710778725
Name:OFOEGBU, ASOLUKA
Entity type:Individual
Prefix:DR
First Name:ASOLUKA
Middle Name:
Last Name:OFOEGBU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 INCA LN
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-6554
Mailing Address - Country:US
Mailing Address - Phone:647-686-4726
Mailing Address - Fax:
Practice Address - Street 1:5475 BECKLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4146
Practice Address - Country:US
Practice Address - Phone:269-979-7710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program