Provider Demographics
NPI:1235192790
Name:NDIFE, ANITA NWAMAKA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:NWAMAKA
Last Name:NDIFE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3525 OLENTANGY RIVER RD STE 4330
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3937
Mailing Address - Country:US
Mailing Address - Phone:614-255-6900
Mailing Address - Fax:614-255-6901
Practice Address - Street 1:3525 OLENTANGY RIVER RD STE 4330
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3937
Practice Address - Country:US
Practice Address - Phone:614-255-6900
Practice Address - Fax:614-255-6901
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35085917207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2571748Medicaid
I29149Medicare UPIN
OHND4157551Medicare PIN