Individual
NIBA FUHNWI NCHOTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501
(512) 730-3056
(888) 730-1925
Mailing address
7500 RIALTO BLVD STE 1-140, AUSTIN, TX 78735-8534
(512) 730-3056
(888) 730-1925
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101019807
MI
207R00000X
Internal Medicine Physician
OC0033
ID
208M00000X
Hospitalist Physician
Primary
DO216470
OR
Other
Enumeration date
04/23/2012
Last updated
08/16/2023
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