Healthcare Provider Details

I. General information

NPI: 1447611579
Provider Name (Legal Business Name): CHIDOZIE ODIGWE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2016
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7007 POWERS BOULEVARD
PARMA OH
44129
US

IV. Provider business mailing address

7007 POWERS BOULEVARD
PARMA OH
44129
US

V. Phone/Fax

Practice location:
  • Phone: 440-743-3006
  • Fax: 440-743-3005
Mailing address:
  • Phone: 440-743-3006
  • Fax: 440-743-3005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTP382
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number344600
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: