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General NPI Number Information
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NPI Number | 1821593021
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Entity Type | Individual
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Provider Name | KELECHI BRENDA ANUDOKEM MD
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Gender | Female
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Dates
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Enumeration Date | 03/28/2018
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Last Update Date | 05/28/2021
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Provider Practice Location Address
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Address Line | 3288 MOANALUA RD
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City | HONOLULU
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State | HI
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Zip | 96819-1469
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Country | US
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Telephone | 808-432-7934
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Fax |
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Provider Business Mailing Address
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Address Line | 525 NELSON RISING LN APT 213
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City | SAN FRANCISCO
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State | CA
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Zip | 94158-2293
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Country | US
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Telephone | 408-667-5703
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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 | 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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