1467637140 NPI number — DR. CHINWE NGOZI NNEKA CHUKWURAH MD

Table of content: DR. CHINWE NGOZI NNEKA CHUKWURAH MD (NPI 1467637140)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467637140 NPI number — DR. CHINWE NGOZI NNEKA CHUKWURAH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHUKWURAH
Provider First Name:
CHINWE
Provider Middle Name:
NGOZI NNEKA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EDEOGU
Provider Other First Name:
CHINWE
Provider Other Middle Name:
NGOZI NNEKA
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1467637140
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/07/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
102 WOODMONT BLVD STE 600
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37205-5250
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:
480-977-1851

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6843 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MESA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85207-8207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-870-7300
Provider Business Practice Location Address Fax Number:
480-906-2172
Provider Enumeration Date:
01/01/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  51733 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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