Individual
CHIKWENDU C NWOSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2919 S ELLSWORTH RD, SUITE 139, MESA, AZ 85212-2164
(917) 474-0025
Mailing address
3846 E LAFAYETTE AVE, GILBERT, AZ 85298-9130
(917) 474-0025
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2006022624
MO
208100000X
Physical Medicine & Rehabilitation Physician
37888
AZ
208M00000X
Hospitalist Physician
37888
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165740001
—
AR
05
—
207579905
—
MO
01
—
216979
BCBS
—
01
—
767486
HEALTHLINK
—
01
—
P00376722
RAILROAD MEDICARE
—
Enumeration date
12/04/2006
Last updated
08/06/2014
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