Provider Demographics
NPI:1154445476
Name:OSUOHA, CHIMA A (MD)
Entity Type:Individual
Prefix:DR
First Name:CHIMA
Middle Name:A
Last Name:OSUOHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3599 S EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-3344
Mailing Address - Country:US
Mailing Address - Phone:702-522-0701
Mailing Address - Fax:702-522-1653
Practice Address - Street 1:3599 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-3344
Practice Address - Country:US
Practice Address - Phone:702-522-0701
Practice Address - Fax:702-522-1653
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV13184207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100500484 GROUPMedicaid
NVVWQBHVMedicare PIN