Provider Demographics
NPI:1104207323
Name:NWOKEABIA, IFEANYI DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:IFEANYI
Middle Name:DAVID
Last Name:NWOKEABIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:CAMPUS BOX 8054
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-6978
Mailing Address - Fax:
Practice Address - Street 1:1105 CENTRAL EXPY N STE 2110
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6122
Practice Address - Country:US
Practice Address - Phone:469-251-8488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-12
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXS8086207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology