Provider Demographics
NPI:1194389122
Name:NDUBUISI, CHIKEZIE
Entity Type:Individual
Prefix:
First Name:CHIKEZIE
Middle Name:
Last Name:NDUBUISI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 V ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1012
Mailing Address - Country:US
Mailing Address - Phone:202-823-9159
Mailing Address - Fax:
Practice Address - Street 1:9 V ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-1012
Practice Address - Country:US
Practice Address - Phone:202-823-9159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-25
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14438374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide