Provider Demographics
NPI:1508976986
Name:NWOSU, MARTIN NWABUNIKE
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:NWABUNIKE
Last Name:NWOSU
Suffix:
Gender:M
Credentials:
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 331648
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37133-1648
Mailing Address - Country:US
Mailing Address - Phone:615-624-6643
Mailing Address - Fax:615-900-1621
Practice Address - Street 1:3163 S CHURCH ST
Practice Address - Street 2:STE B
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37127-7175
Practice Address - Country:US
Practice Address - Phone:615-624-6643
Practice Address - Fax:615-900-1625
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN42730207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine