Healthcare Provider Details

I. General information

NPI: 1114160496
Provider Name (Legal Business Name): CHIBUIKE BRUNO OBIOHA M.B.,B.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2009
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4834 SOCIALVILLE FOSTER RD STE 10
MASON OH
45040-6805
US

IV. Provider business mailing address

4834 SOCIALVILLE FOSTER RD STE 10
MASON OH
45040-6805
US

V. Phone/Fax

Practice location:
  • Phone: 513-306-4910
  • Fax:
Mailing address:
  • Phone: 513-306-4910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.132134
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35.132134
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number35.132134
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number35.132134
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: