Provider Demographics
NPI:1205843042
Name:NWANKWO, CHIKE OBIOMA (MD)
Entity Type:Individual
Prefix:DR
First Name:CHIKE
Middle Name:OBIOMA
Last Name:NWANKWO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1842 BEACON ST STE 403A
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-1922
Mailing Address - Country:US
Mailing Address - Phone:617-230-0500
Mailing Address - Fax:
Practice Address - Street 1:1842 BEACON ST STE 403A
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-1922
Practice Address - Country:US
Practice Address - Phone:617-230-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2015-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2192412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry