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General NPI Number Information
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NPI Number | 1760113187
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Entity Type | Individual
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Provider Name | IFEOMA O. NWAEDOZIE DPM
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Gender | Female
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Dates
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Enumeration Date | 06/17/2022
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 101 JOHN MADDOX DR NW STE A
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City | ROME
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State | GA
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Zip | 30165-1481
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Country | US
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Telephone | 706-232-6739
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Fax | 706-232-6750
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Provider Business Mailing Address
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Address Line | 101 JOHN MADDOX DR NW STE A
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City | ROME
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State | GA
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Zip | 30165-1481
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Country | US
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Telephone | 706-232-6739
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Fax | 706-232-6750
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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 | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | POD305049
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License Number State | GA
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