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General NPI Number Information
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NPI Number | 1043341944
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Entity Type | Individual
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Provider Name | BENNETT ONYEMA NWANKPA M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 222 E GATEHOUSE DR APT. D
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City | METAIRIE
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State | LA
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Zip | 70001-2133
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Country | US
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Telephone | 504-837-4421
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Fax | 504-837-4421
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Provider Business Mailing Address
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Address Line | 222 E GATEHOUSE DR APT. D
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City | METAIRIE
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State | LA
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Zip | 70001-2133
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Country | US
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Telephone | 504-837-4421
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Fax | 504-837-4421
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 07047R
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License Number State | LA
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