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Individual

DR. VIVIAN CHIZOROM IWU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.P.M.

Contact information

Practice address
540 POWDER SPRINGS ST STE B6, MARIETTA, GA 30064-3559
(770) 702-8723
(770) 702-8809
Mailing address
2450 ATLANTA HWY, STE 402, CUMMING, GA 30040-1254
(678) 947-0973
(678) 947-2836

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001071
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
924062921A
GA
01
P00460780
RAILROAD MEDICARE
GA
Enumeration date
04/03/2007
Last updated
09/11/2020
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