Provider Demographics
NPI:1275113607
Name:NSONWU, VIVIEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:VIVIEN
Middle Name:C
Last Name:NSONWU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 BOUSH ST PH 35
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1370
Mailing Address - Country:US
Mailing Address - Phone:317-522-8408
Mailing Address - Fax:
Practice Address - Street 1:450 BOUSH ST PH 35
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1370
Practice Address - Country:US
Practice Address - Phone:317-522-8408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program