Provider Demographics
NPI:1255526588
Name:NWAONU, JANE N (MD)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:N
Last Name:NWAONU
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3 RIVERSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4955
Mailing Address - Country:US
Mailing Address - Phone:540-224-5170
Mailing Address - Fax:540-526-1099
Practice Address - Street 1:3 RIVERSIDE CIR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4955
Practice Address - Country:US
Practice Address - Phone:540-224-5170
Practice Address - Fax:540-526-1099
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP1119207RR0500X
OH092697207RR0500X
SD7705207RR0500X
VA0101263687207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX75-2616977-021OtherTRICARE
TXP01093491OtherRAIL ROAD
TX306416401Medicaid
TX8DD490OtherBCBS
TX306416401Medicaid