Individual provider · NPI-1
Destiny Aighobahi
Surgery · Southfield, MI
NPI number1861016131
StatusActive
Last updated in NPPESJun 6, 2020
Details
- NPI
- 1861016131
- Entity type
- Individual (NPI-1)
- Name
- Destiny Aighobahi
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 3, 2020
- Certification date
- Jun 6, 2020
- Last updated
- Jun 6, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | 4351047009 | MI | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
16001 W 9 Mile Rd OfcSouthfield, MI 48075-4818
Phone 248-849-8902
Mailing address
9504 Empire Rock StLas Vegas, NV 89143-1375
Phone 678-358-9748
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