Provider Demographics
NPI:1558337063
Name:NWADIKE, JOY AKUNNA (MD)
Entity Type:Individual
Prefix:DR
First Name:JOY
Middle Name:AKUNNA
Last Name:NWADIKE
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:PO BOX 12938
Mailing Address - Street 2:C/O CLINIC MANAGEMENT
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30703-7013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:170 CURTIS PKWY NE
Practice Address - Street 2:SUITE 1
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-2062
Practice Address - Country:US
Practice Address - Phone:706-879-5770
Practice Address - Fax:706-624-4336
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA56863207V00000X
TN39311207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA205969416DMedicaid
GA205969416EMedicaid
202I052718Medicare UPIN