MEDICARE: DR. AUGUSTINE O. CHIKEZIE 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	2080P0205X	Pediatric Endocrinology Physician	MA05978100	NJ

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669562393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUGUSTINE O. CHIKEZIE MD

Provider Business Mailing Address
First Line	:	6712 WASHINGTON AVE
Second Line	:	SUITE 203
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-1999
Country	:	US
Telephone Number	:	609-641-1155
Fax Number	:	609-641-1140

Provider Business Practice Location Address
First Line	:	6712 WASHINGTON AVE
Second Line	:	SUITE 203
City	:	EGG HARBOR TWP
State	:	NJ
Zip	:	08234-1999
Country	:	US
Telephone Number	:	609-641-1155
Fax Number	:	609-641-1140

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

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	05/11/2012

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Directions to “ DR. AUGUSTINE O. CHIKEZIE MD” Practice Location

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