Healthcare Provider Details

I. General information

NPI: 1376650275
Provider Name (Legal Business Name): CHIOMA R EKECHUKWU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 SAM RITTENBERG BLVD STE 2011
CHARLESTON SC
29407-4631
US

IV. Provider business mailing address

4200 IRVINGTON DR
CHARLOTTE NC
28205-4635
US

V. Phone/Fax

Practice location:
  • Phone: 843-793-2104
  • Fax: 843-654-4850
Mailing address:
  • Phone: 404-538-3943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number056994
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2007-00232
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number29267
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: