Provider Demographics
NPI:1134670474
Name:EKE, CHIBUZOR STEVE (MBBCH, MPH, MSN, FNP)
Entity Type:Individual
Prefix:DR
First Name:CHIBUZOR
Middle Name:STEVE
Last Name:EKE
Suffix:
Gender:M
Credentials:MBBCH, MPH, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 BRADMERE LN
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-3252
Mailing Address - Country:US
Mailing Address - Phone:770-866-7016
Mailing Address - Fax:
Practice Address - Street 1:503 COMMERCE PARK DR SE
Practice Address - Street 2:SUITE E
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-2781
Practice Address - Country:US
Practice Address - Phone:770-866-7016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-21
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN221151363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily