MEDICARE: NWABUNDO IFEYINWA ANUSIM M.D

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	207RH0003X	Hematology & Oncology Physician	T1281	TX

General Provider Information

NPI Number	:	1144504408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NWABUNDO IFEYINWA ANUSIM M.D

Provider Business Mailing Address
First Line	:	1601 TRINITY ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78712-1765
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 TRINITY ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78712-1765
Country	:	US
Telephone Number	:	574-335-5000
Fax Number	:

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

Provider Enumeration Date	:	10/05/2011
Last Update Date	:	03/25/2026

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