Individual
DR. DE GAULLE I CHIGBU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1200 W GODFREY AVE, PHILADELPHIA, PA 19141-3323
(215) 276-6000
Mailing address
7602 MASSEY WAY # B, ELKINS PARK, PA 19027-1010
(215) 887-0946
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001442
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101108790001
—
PA
01
—
1640750
BLUE SHIELD
PA
Enumeration date
08/04/2006
Last updated
02/15/2012
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