Individual
CHARLES CHUKWAMA OKORO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-2501
(317) 988-3243
Mailing address
3504 IDLEWOOD PKWY, APT 502, INDIANAPOLIS, IN 46214-1988
(317) 328-8366
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01058999A
IN
207R00000X
Internal Medicine Physician
01058999A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000613056
ANTHEM BCBS
IN
05
—
200846210
—
IN
Enumeration date
07/13/2006
Last updated
04/12/2022
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