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NPI Code Detail

MEDICARE: YAHNICK CHIZARAM MADUMERE MD

MEDICARE: YAHNICK CHIZARAM MADUMERE 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 : 1518752112
Entity Type Code : Individual
Provider Name (Legal Business Name) : YAHNICK CHIZARAM MADUMERE MD
Provider Business Mailing Address
First Line : 13624 RODERICK DR
Second Line :
City : HUNTERSVILLE
State : NC
Zip : 28078-0677
Country : US
Telephone Number : 919-590-2912
Fax Number :
Provider Business Practice Location Address
First Line : 1000 BLYTHE BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-5871
Country : US
Telephone Number : 919-590-2912
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2025
Last Update Date : 12/17/2025

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