Healthcare Provider Details

I. General information

NPI: 1841752029
Provider Name (Legal Business Name): CHIJIOKE VICTOR OHAMADIKE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2019
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 WALTON WAY
AUGUSTA GA
30901-2612
US

IV. Provider business mailing address

4060 CRIMSON PASS
GRANITEVILLE SC
29829-3265
US

V. Phone/Fax

Practice location:
  • Phone: 706-722-9011
  • Fax:
Mailing address:
  • Phone: 908-494-8631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number100485
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: