Healthcare Provider Details

I. General information

NPI: 1467637140
Provider Name (Legal Business Name): CHINWE NGOZI NNEKA CHUKWURAH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHINWE NGOZI NNEKA EDEOGU MD

II. Dates (important events)

Enumeration Date: 01/01/2008
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6843 E MAIN ST
MESA AZ
85207-8207
US

IV. Provider business mailing address

102 WOODMONT BLVD STE 600
NASHVILLE TN
37205-5250
US

V. Phone/Fax

Practice location:
  • Phone: 480-870-7300
  • Fax: 480-906-2172
Mailing address:
  • Phone:
  • Fax: 480-977-1851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number51733
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: