Healthcare Provider Details

I. General information

NPI: 1518756881
Provider Name (Legal Business Name): DR. CHIDI ASUZU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2025
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

178 SUMMIT POINTE LN
DALLAS GA
30132-3188
US

IV. Provider business mailing address

178 SUMMIT POINTE LN
DALLAS GA
30132-3188
US

V. Phone/Fax

Practice location:
  • Phone: 415-261-2272
  • Fax:
Mailing address:
  • Phone: 415-261-2272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: