Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kellya Annisa Ubokudom, DO

Individual provider Emergency Medicine Physician · NPI 1104213164

Kellya Annisa Ubokudom, DO is an Emergency Medicine Physician in Ann Arbor, Michigan. Works from 2 locations. Licensed in Michigan and Ohio.

Licensed in
MI, OH
In the registry since
2015
Specialties on file
4
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone: (734) 936-4000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 500 Euclid Ave E19, Cleveland, OH 44195-2664 — (216) 445-9175

Specialties & licences

Pediatric Emergency Medicine (Emergency Medicine) Physician (primary) Taxonomy 207PP0204X · Licence 5101021815 (MI)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 34013380 (OH)
Pediatrics Physician Taxonomy 208000000X · Licence 5101021815 (MI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1104213164
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 16, 2015
Last updated in NPPESNovember 7, 2022
Certification dateNovember 7, 2022
Mailing address3621 S State St, Ann Arbor, MI 48108-1633

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