Healthcare Provider Details

I. General information

NPI: 1497045496
Provider Name (Legal Business Name): NDUCHE CHIKA ONYEASO M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2011
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 ROBESON ST SUITE 405
FAYETTEVILLE NC
28301-5552
US

IV. Provider business mailing address

1638 OWEN DR ATTN: MANAGED CARE PLANNING
FAYETTEVILLE NC
28304-3424
US

V. Phone/Fax

Practice location:
  • Phone: 910-615-1623
  • Fax: 910-321-6248
Mailing address:
  • Phone: 910-615-6949
  • Fax: 910-615-9761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number2013-01479
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2013-01479
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: