MEDICARE: DR. OKECHUKWU NWABUEZE OBI MD

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	207RX0202X	Medical Oncology Physician	24703	NV
2	207R00000X	Internal Medicine Physician	24703	NV
3	207RH0000X	Hematology (Internal Medicine) Physician	24703	NV
4	207RH0003X	Hematology & Oncology Physician	036152827	IL

General Provider Information

NPI Number	:	1083134704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OKECHUKWU NWABUEZE OBI MD

Provider Business Mailing Address
First Line	:	PO BOX 35380
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5380
Country	:	US
Telephone Number	:	702-954-7457
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2149
Country	:	US
Telephone Number	:	702-724-8787
Fax Number	:

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

Provider Enumeration Date	:	06/23/2017
Last Update Date	:	02/04/2026

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