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Individual

MR. KENECHUKWU NWAGBARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
162 BMH PHYSICIANS OFFICE BLDG, MARYVILLE, TN 37804-5902
(865) 238-6161
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2018023739
MO
207RC0000X
Cardiovascular Disease Physician
Primary
74653
TN
207RI0011X
Interventional Cardiology Physician
036177610
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q103955
TN
Enumeration date
03/30/2015
Last updated
12/18/2025
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