Provider Demographics
NPI:1184850505
Name:NWACHUKU, ADAKU U (DO)
Entity Type:Individual
Prefix:
First Name:ADAKU
Middle Name:U
Last Name:NWACHUKU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7801 OLD BRANCH AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-1642
Mailing Address - Country:US
Mailing Address - Phone:202-221-8442
Mailing Address - Fax:202-221-8443
Practice Address - Street 1:7801 OLD BRANCH AVE
Practice Address - Street 2:STE 202
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1642
Practice Address - Country:US
Practice Address - Phone:202-221-8442
Practice Address - Fax:202-221-8443
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDO034629208100000X
NY252614-12081P2900X
MDH00775162081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD451944OtherMEDICARE PTAN
DC451911OtherMEDICARE PTAN