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NPI Code Detail

MEDICARE: CHIEDOZIE IKENNA ANOCHI WATURUOCHA MD

MEDICARE: CHIEDOZIE IKENNA ANOCHI WATURUOCHA 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1366384323
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHIEDOZIE IKENNA ANOCHI WATURUOCHA MD
Provider Business Mailing Address
First Line : 615 S NEW BALLAS RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63141-8221
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 615 S NEW BALLAS RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63141-8221
Country : US
Telephone Number : 314-251-6930
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2026
Last Update Date : 04/08/2026

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