Provider Demographics
NPI:1083135966
Name:MBACHI, CHIMEZIE UCHENNA (MD)
Entity Type:Individual
Prefix:DR
First Name:CHIMEZIE
Middle Name:UCHENNA
Last Name:MBACHI
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 1:7557B DANNAHER DR STE 225
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-3568
Mailing Address - Country:US
Mailing Address - Phone:865-859-7330
Mailing Address - Fax:865-859-7339
Practice Address - Street 1:7557B DANNAHER DR STE 225
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-3568
Practice Address - Country:US
Practice Address - Phone:865-859-7330
Practice Address - Fax:865-859-7339
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD66541207RG0100X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology