Healthcare Provider Details

I. General information

NPI: 1982824207
Provider Name (Legal Business Name): NNEKA STELLA ANYANECHI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NNEKA STELLA EZENEKE MD

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 W BROAD ST
COLUMBUS OH
43228-1607
US

IV. Provider business mailing address

8419 RUTHERFORD ESTATES DR
POWELL OH
43065-7227
US

V. Phone/Fax

Practice location:
  • Phone: 614-288-5340
  • Fax:
Mailing address:
  • Phone: 614-288-5340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number35.082098
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35082098
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.082098
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: