Individual
CHIDIMMA I OKOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 GROVE ST STE 210, WORCESTER, MA 01605
(508) 556-1072
Mailing address
100 GROVE ST STE 210, WORCESTER, MA 01605-2627
(508) 556-1072
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
253584
MA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
253584
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110100196A
—
MA
Enumeration date
06/03/2010
Last updated
12/02/2020
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