Provider Demographics
NPI:1366645848
Name:NWOBU, IKECHUKWU ONYEKACHI
Entity type:Individual
Prefix:DR
First Name:IKECHUKWU
Middle Name:ONYEKACHI
Last Name:NWOBU
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 1:100 KIMEL FOREST DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6074
Mailing Address - Country:US
Mailing Address - Phone:336-716-1331
Mailing Address - Fax:336-716-3202
Practice Address - Street 1:4515 PREMIER DR
Practice Address - Street 2:STE 403
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8357
Practice Address - Country:US
Practice Address - Phone:336-802-2930
Practice Address - Fax:336-802-2931
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200800200174400000X
NC2008-00200207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No174400000XOther Service ProvidersSpecialist