MEDICARE: DR. CHIDINMA C NWAKANMA 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	207P00000X	Emergency Medicine Physician	MD460977	PA

General Provider Information

NPI Number	:	1285977538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHIDINMA C NWAKANMA MD

Provider Business Mailing Address
First Line	:	51 N 39TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-2640
Country	:	US
Telephone Number	:	215-662-8214
Fax Number	:	215-662-3953

Provider Business Practice Location Address
First Line	:	51 N 39TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-2640
Country	:	US
Telephone Number	:	215-662-8214
Fax Number	:	215-662-3953

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

Provider Enumeration Date	:	04/04/2013
Last Update Date	:	03/19/2026

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