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Individual

DR. MICHAEL CHIEBONAM OBICHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1402 E COUNTY LINE RD, INDIANAPOLIS, IN 46227-0963
(317) 887-7805
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2805

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01069522A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000977209
ANTHEM
IN
05
201022320
IN
01
P01824525
RR PTAN
IN
Enumeration date
07/03/2008
Last updated
05/17/2021
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