Individual
DR. IFEANYICHUKWU MADUBOBI ERUCHALU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 E CHEVES ST, SUITE 202, FLORENCE, SC 29506-2615
(843) 777-7863
(843) 777-7873
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 777-7863
(843) 777-7873
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
22684
SC
207RP1001X
Pulmonary Disease Physician
Primary
22684
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30791
BCBS
NC
01
—
43275
PARTNERS
—
01
—
7007102
AETNA
—
05
—
8930791
—
NC
Enumeration date
07/26/2006
Last updated
01/14/2014
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