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General NPI Number Information
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NPI Number | 1386328060
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Entity Type | Individual
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Provider Name | CHUKWUDI AMARACHUKWU NWOGU M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2023
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 3 RIVERSIDE CIRCLE, 2ND FLOOR NEUROLOGY DEPARTMENT
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City | ROANOKE
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State | VA
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Zip | 24016
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Country | US
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Telephone | 540-224-5170
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Fax | 540-985-9612
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Provider Business Mailing Address
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Address Line | 3330 CIRCLE BROOK DRIVE, APARTMENT F, ROANOKE
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City | ROANOKE
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State | VA
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Zip | 24018
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Country | US
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Telephone | 540-597-3357
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Fax | 540-985-9612
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 0116038505
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License Number State | VA
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