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NPI Code Detail

MEDICARE: DR. NWAOBIARA OBI-GWACHAM MD

MEDICARE: DR. NWAOBIARA OBI-GWACHAM 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 Physician200300856NC

Other Identifiers

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

General Provider Information

NPI Number : 1619971587
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NWAOBIARA OBI-GWACHAM MD
Provider Business Mailing Address
First Line : PO BOX 40908
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28309-0908
Country : US
Telephone Number : 910-615-6448
Fax Number : 910-615-5070
Provider Business Practice Location Address
First Line : 2300 RAMSEY ST
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28301-3856
Country : US
Telephone Number : 910-488-2120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 07/26/2019

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Directions to “ DR. NWAOBIARA OBI-GWACHAM MD” Practice Location

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