Individual
DR. CHIGOZIE EBELENNA MORONU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
820 PRUDENTIAL DR STE 304, JACKSONVILLE, FL 32207-8205
(904) 202-3860
(904) 202-3846
Mailing address
PO BOX 45443, SALT LAKE CITY, UT 84145-0443
(904) 202-1032
(904) 376-4107
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101253722
VA
207R00000X
Internal Medicine Physician
ME143340
FL
208M00000X
Hospitalist Physician
0101253722
VA
208M00000X
Hospitalist Physician
Primary
ME143340
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962740183
—
VA
Enumeration date
01/23/2013
Last updated
06/10/2020
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