MEDICARE: EMMANUEL C ANEKWE MD

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	207R00000X	Internal Medicine Physician	N1530	TX
2	207RN0300X	Nephrology Physician	N1530	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205871720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMANUEL C ANEKWE MD

Provider Business Mailing Address
First Line	:	PO BOX 221408
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79913-4408
Country	:	US
Telephone Number	:	915-307-7800
Fax Number	:	915-351-4001

Provider Business Practice Location Address
First Line	:	7500 N MESA ST STE 210
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-3515
Country	:	US
Telephone Number	:	915-307-7800
Fax Number	:	915-351-4001

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

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	01/23/2025

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