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General NPI Number Information
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NPI Number | 1134670474
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Entity Type | Individual
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Provider Name | CHIBUZOR STEVE EKE MBBCH, MPH, MSN, FNP
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Gender | Male
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Dates
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Enumeration Date | 10/21/2016
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 1668 MULKEY RD STE G
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City | AUSTELL
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State | GA
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Zip | 30106-1163
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Country | US
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Telephone | 404-585-4964
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Fax | 404-581-5838
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Provider Business Mailing Address
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Address Line | 5878 GRAYWOOD CIR SE
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City | MABLETON
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State | GA
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Zip | 30126-2894
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Country | US
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Telephone | 770-866-7016
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Fax |
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 221151
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN221151
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License Number State | GA
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