MEDICARE: MR. CHUKWUEMEKA NWAKAMMA NJOKU

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	225000000X	Orthotic Fitter	CFTS0989	NC

General Provider Information

NPI Number	:	1285964395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHUKWUEMEKA NWAKAMMA NJOKU

Provider Business Mailing Address
First Line	:	100 E SIX FORKS RD
Second Line	:	SUITE 130
City	:	RALEIGH
State	:	NC
Zip	:	27609-7752
Country	:	US
Telephone Number	:	919-881-8210
Fax Number	:	919-784-9498

Provider Business Practice Location Address
First Line	:	100 E SIX FORKS RD
Second Line	:	SUITE 130
City	:	RALEIGH
State	:	NC
Zip	:	27609-7752
Country	:	US
Telephone Number	:	919-881-8210
Fax Number	:	919-784-9498

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

Provider Enumeration Date	:	01/12/2010
Last Update Date	:	01/12/2010

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