MEDICARE: DR. VICTOR MADUABUCHI NWILOH M.D.

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	207R00000X	Internal Medicine Physician	ME91251	FL
2	207R00000X	Internal Medicine Physician	MD00047521	WA
3	207R00000X	Internal Medicine Physician	ME 91251	FL
4	207R00000X	Internal Medicine Physician	N5914	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00388656	OTHER	WA	RR MCARE
2	53528	OTHER	FL	BCBS
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	:	1851338032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTOR MADUABUCHI NWILOH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 963207
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79996-3207
Country	:	US
Telephone Number	:	915-300-2276
Fax Number	:	866-665-6659

Provider Business Practice Location Address
First Line	:	2204 JOE BATTLE BLVD # D204
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79938-4660
Country	:	US
Telephone Number	:	915-300-2276
Fax Number	:	866-665-6659

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

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	06/08/2020

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