Provider Demographics
NPI:1033341656
Name:NWEKE, CHINEDU PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:CHINEDU
Middle Name:PATRICK
Last Name:NWEKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1720 MARS HILL RD NW STE 120-380
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-7127
Mailing Address - Country:US
Mailing Address - Phone:470-227-8130
Mailing Address - Fax:470-747-7588
Practice Address - Street 1:4450 CALIBRE XING NW STE 1126
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-4104
Practice Address - Country:US
Practice Address - Phone:470-227-8130
Practice Address - Fax:470-747-7588
Is Sole Proprietor?:No
Enumeration Date:2009-08-14
Last Update Date:2022-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA78384207RN0300X, 207RN0300X
390200000X
NMMD2014-0270207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003204382JMedicaid