Healthcare Provider Details

I. General information

NPI: 1275030132
Provider Name (Legal Business Name): KELECHI ONYEKACHI WEZE MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 MANCHESTER EXPY STE 1001
COLUMBUS GA
31904-6877
US

IV. Provider business mailing address

2300 MANCHESTER EXPY STE 1001
COLUMBUS GA
31904-6877
US

V. Phone/Fax

Practice location:
  • Phone: 706-322-0528
  • Fax: 706-322-2080
Mailing address:
  • Phone: 706-322-0528
  • Fax: 706-322-2080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number89295
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: