Individual
DR. MICHAEL CHUKWUMA ODIBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1215 MEDICAL CENTER DR, WILMINGTON, NC 28401-7306
(910) 228-5894
(888) 836-5759
Mailing address
1215 MEDICAL CENTER DR, WILMINGTON, NC 28401-7306
(910) 228-5894
(910) 228-5897
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2015-01360
NC
207R00000X
Internal Medicine Physician
25MA08470600
NJ
207R00000X
Internal Medicine Physician
4301091533
MI
208M00000X
Hospitalist Physician
251015
NY
208M00000X
Hospitalist Physician
42141
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000592390
ANTHEM BCBS
KY
05
—
7100061340
—
KY
Enumeration date
04/30/2008
Last updated
10/23/2024
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