Healthcare Provider Details

I. General information

NPI: 1306571013
Provider Name (Legal Business Name): JUDE NZUONKWELLE NKWELLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2022
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

1237 WASHINGTON AVE APT 711
CLEVELAND OH
44113-2363
US

V. Phone/Fax

Practice location:
  • Phone: 216-983-5627
  • Fax: 216-844-4741
Mailing address:
  • Phone: 623-200-8395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35.155467
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: