Healthcare Provider Details

I. General information

NPI: 1750944559
Provider Name (Legal Business Name): ESTHER UDOCHUKWUKAOSUJI NWANKWO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ESTHER OSUJI

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1160 W MICHIGAN ST
INDIANAPOLIS IN
46202-5209
US

IV. Provider business mailing address

250 N SHADELAND AVE
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-944-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number01101155A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number74381
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: