Healthcare Provider Details

I. General information

NPI: 1437542677
Provider Name (Legal Business Name): ODINAKA ABIGAIL NWANKWO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2015
Last Update Date: 01/05/2023
Certification Date: 01/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 HIGHWAY 6 WEST
IOWA IA
52446
US

IV. Provider business mailing address

4566 LUKE DR
IOWA CITY IA
52246-8635
US

V. Phone/Fax

Practice location:
  • Phone: 319-338-0581
  • Fax: 319-339-0581
Mailing address:
  • Phone: 319-379-5342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number99156
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number019919
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: