Provider Demographics
NPI:1477657807
Name:NWAUKWA, CHIMA CHRISTIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHIMA
Middle Name:CHRISTIAN
Last Name:NWAUKWA
Suffix:
Gender:M
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:PO BOX 12600
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77726-2600
Mailing Address - Country:US
Mailing Address - Phone:409-832-6200
Mailing Address - Fax:409-832-6216
Practice Address - Street 1:740 HOSPITAL DR STE 200
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4663
Practice Address - Country:US
Practice Address - Phone:409-832-6200
Practice Address - Fax:409-832-6216
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4901207RC0000X, 207RI0011X
IL036103705207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
I38164Medicare UPIN