MEDICARE: CHINEDU D EDE M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	E-9414	AR
2	208M00000X	Hospitalist Physician	E-9414	AR

General Provider Information

NPI Number	:	1043553167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHINEDU D EDE M.D

Provider Business Mailing Address
First Line	:	4310 W MARKHAM ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-4024
Country	:	US
Telephone Number	:	501-686-6560
Fax Number	:

Provider Business Practice Location Address
First Line	:	4310 W MARKHAM ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-4024
Country	:	US
Telephone Number	:	501-686-6560
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2013
Last Update Date	:	07/29/2024

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Directions to “ CHINEDU D EDE M.D” Practice Location

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