Healthcare Provider Details

I. General information

NPI: 1376702811
Provider Name (Legal Business Name): CHUKWUEMEKA OBIORA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: EMEKA OBIORA M.D.

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MEDICAL PARK RD STE 300
COLUMBIA SC
29203-6839
US

IV. Provider business mailing address

300 E MCBEE AVE STE 300
GREENVILLE SC
29601-2899
US

V. Phone/Fax

Practice location:
  • Phone: 803-434-8800
  • Fax: 803-929-0492
Mailing address:
  • Phone: 864-522-8611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number94041
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2013-00727
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101259045
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number91765
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: