MEDICARE: DR. NDIDI NWAMU D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	OS015484	PA
2	207RN0300X	Nephrology Physician	OS11673	FL
3	207R00000X	Internal Medicine Physician	OS11673	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023273588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NDIDI NWAMU D.O.

Provider Business Mailing Address
First Line	:	2601 HOLME AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-2007
Country	:	US
Telephone Number	:	407-482-4101
Fax Number	:	407-482-4157

Provider Business Practice Location Address
First Line	:	900 PLYMOUTH AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32805-3744
Country	:	US
Telephone Number	:	407-482-4101
Fax Number	:	321-247-6910

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2008
Last Update Date	:	05/14/2025

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