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NPI Code Detail

MEDICARE: DR. ANNETA N. OSUCHUKWU MD

MEDICARE: DR. ANNETA N. OSUCHUKWU 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
1207R00000XInternal Medicine PhysicianLL4411NV
2208D00000XGeneral Practice PhysicianLL4411NV

General Provider Information

NPI Number : 1124355854
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANNETA N. OSUCHUKWU MD
Provider Business Mailing Address
First Line : 361 ROYDALE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89183-3551
Country : US
Telephone Number : 917-627-8159
Fax Number :
Provider Business Practice Location Address
First Line : 8280 W WARM SPRINGS RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-3612
Country : US
Telephone Number : 702-492-8237
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2009
Last Update Date : 06/15/2026

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