Provider Demographics
NPI:1568882272
Name:ONYEUKU, NASARACHI (MD)
Entity Type:Individual
Prefix:
First Name:NASARACHI
Middle Name:
Last Name:ONYEUKU
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 1:1800 HOSPITAL SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-8114
Mailing Address - Country:US
Mailing Address - Phone:770-793-7196
Mailing Address - Fax:
Practice Address - Street 1:1800 HOSPITAL SOUTH DR
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-8114
Practice Address - Country:US
Practice Address - Phone:770-793-7196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-21
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC390200000X
GA836252085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program