MEDICARE: CHIGOZIE C CHIDEBELU

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	363LF0000X	Family Nurse Practitioner	143479	AL

General Provider Information

NPI Number	:	1821827114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHIGOZIE C CHIDEBELU

Provider Business Mailing Address
First Line	:	300 SUN TEMPLE DR
Second Line	:
City	:	MADISON
State	:	AL
Zip	:	35758-5919
Country	:	US
Telephone Number	:	256-325-9111
Fax Number	:	256-325-9113

Provider Business Practice Location Address
First Line	:	300 SUN TEMPLE DR
Second Line	:
City	:	MADISON
State	:	AL
Zip	:	35758-5919
Country	:	US
Telephone Number	:	256-325-9111
Fax Number	:	256-325-9113

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

Provider Enumeration Date	:	07/26/2024
Last Update Date	:	04/13/2026

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Directions to “ CHIGOZIE C CHIDEBELU ” Practice Location

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