Provider Demographics
NPI:1417650425
Name:CHUDE, LINDA KOSISOCHUKWU (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:KOSISOCHUKWU
Last Name:CHUDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:KOSISOCHUKWU
Other - Last Name:EPUNDU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12920 OAKDALE ST
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-8505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2466 FLOWOOD DR STE E
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9019
Practice Address - Country:US
Practice Address - Phone:601-815-5700
Practice Address - Fax:601-815-5795
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST-4894207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine