Provider Demographics
NPI:1235322546
Name:CHUKWUMAH, CHIKE V (MD)
Entity Type:Individual
Prefix:
First Name:CHIKE
Middle Name:V
Last Name:CHUKWUMAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:85 SEYMOUR ST
Mailing Address - Street 2:SUITE 415
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5501
Mailing Address - Country:US
Mailing Address - Phone:860-246-2071
Mailing Address - Fax:860-524-2650
Practice Address - Street 1:85 SEYMOUR ST
Practice Address - Street 2:SUITE 415
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5501
Practice Address - Country:US
Practice Address - Phone:860-246-2071
Practice Address - Fax:860-524-2650
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
CT048800208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT061406459OtherGREAT WEST HEALTHCARE
CT061406459OtherUNITED HEALTHCARE
CT061406459OtherCOMMUNITY HEALTH NETWORK
CT061406459OtherTRICARE
CT1253522546OtherAETNA
CT061406459OtherPRIVATE HEALTHCARE SYSTEMS
CT1253522546OtherANTHEM BCBS