Individual
KINGSLEY NWOKELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 274-0275
(317) 274-0256
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01090182A
IN
207L00000X
Anesthesiology Physician
036172477
IL
207L00000X
Anesthesiology Physician
Primary
83083
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
095200152
MEDICARE PTAN
IN
05
—
1992265441
—
WI
05
—
300076494
—
IN
Enumeration date
03/21/2019
Last updated
01/31/2025
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