Individual
EJIOFOR CHIKA ACHALU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5165 MCCARTY LN, LAFAYETTE, IN 47905-8764
(765) 448-8000
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01096718A
IN
208D00000X
General Practice Physician
P110445
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01096718A
PHYSICIAN LICENSE
IN
01
—
1105326166
ANTHEM
IN
05
—
300117725
—
IN
01
—
P110445
PHYSICIAN LIMITED PERMIT
NY
Enumeration date
07/12/2021
Last updated
01/08/2026
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