Healthcare Provider Details

I. General information

NPI: 1871584656
Provider Name (Legal Business Name): CHUMA G OSUJI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CHUMA G OSUJI D.O

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6351 W LAKE RD
ERIE PA
16505-2676
US

IV. Provider business mailing address

2752 CARLETON CT
ERIE PA
16506-1356
US

V. Phone/Fax

Practice location:
  • Phone: 814-838-9191
  • Fax:
Mailing address:
  • Phone: 813-732-5505
  • Fax: 813-878-2224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS8399
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberOS010091L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: