Basic Information
| Provider Information | |||||||||
| NPI: | 1154995306 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHUKWU | ||||||||
| FirstName: | CHIKA | ||||||||
| MiddleName: | IHEOMA | ||||||||
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| Credential: | MD, MSC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PEDIATRIC EDUCATION OFFICE CAMPUS BOX 7593 | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275997593 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199663172 | ||||||||
| FaxNumber: | 9199668419 | ||||||||
| Practice Location | |||||||||
| Address1: | 301 E WENDOVER AVE STE 400 | ||||||||
| Address2: | |||||||||
| City: | GREENSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 274011207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368323150 | ||||||||
| FaxNumber: | 3368323152 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2021 | ||||||||
| LastUpdateDate: | 05/13/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | CHUK-01N2MQ | NC | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.