Provider Demographics
NPI:1023506920
Name:NWACHUKWU, CHIJIOKE HORACE
Entity type:Individual
Prefix:DR
First Name:CHIJIOKE
Middle Name:HORACE
Last Name:NWACHUKWU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 BIG OAK LN
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-3805
Mailing Address - Country:US
Mailing Address - Phone:786-333-9749
Mailing Address - Fax:
Practice Address - Street 1:1661 BIG OAK LN
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-3805
Practice Address - Country:US
Practice Address - Phone:786-333-9749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor