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General NPI Number Information
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NPI Number | 1114912557
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Entity Type | Individual
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Provider Name | CHINEDU UZOMA MADUAKOLAM MD
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Gender | Male
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 6865 PARKDALE PL SUITE A
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City | INDIANAPOLIS
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State | IN
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Zip | 46254-5654
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Country | US
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Telephone | 317-291-1211
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Fax | 317-291-1194
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Provider Business Mailing Address
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Address Line | 6865 PARKDALE PL SUITE A
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City | INDIANAPOLIS
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State | IN
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Zip | 46254-5654
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Country | US
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Telephone | 317-291-1211
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Fax | 317-291-1194
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 01060259A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 01060259A
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License Number State | IN
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