Individual
CHINENYE U EZE-RAPHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2651 E DISCOVERY PKWY, BLOOMINGTON, IN 47408-9059
(812) 676-4102
(812) 676-4106
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01087442A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/23/2019
Last updated
06/09/2022
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