Provider Demographics
NPI:1518923465
Name:ONYEKWERE, OSITA ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:OSITA
Middle Name:ANTHONY
Last Name:ONYEKWERE
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 1:1129 CHRISTINE AVE
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-4657
Mailing Address - Country:US
Mailing Address - Phone:256-237-0025
Mailing Address - Fax:
Practice Address - Street 1:1129 CHRISTINE AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-4657
Practice Address - Country:US
Practice Address - Phone:256-237-0025
Practice Address - Fax:256-237-4795
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19196174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1750337085OtherTRICARE / CVC
AL1518923465OtherTRICARE
AL51519294OtherBLUE CROSS BLUE SHIELD OF ALABAMA / OXFORD OFFICE
AL1518923465OtherRAILROAD MEDICARE
AL51040664OtherBLUE CROSS BLUE SHIELD OF ALABAMA / ANNISTON OFFICE
AL529900890Medicaid
AL1518923465OtherTRICARE
AL1750337085OtherTRICARE / CVC