Provider Demographics
NPI:1629245485
Name:ONUORAH, CHINEDU CHRISTIAN (MD,)
Entity Type:Individual
Prefix:DR
First Name:CHINEDU
Middle Name:CHRISTIAN
Last Name:ONUORAH
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 1:210 SMITH CHURCH RD STE B
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-4942
Mailing Address - Country:US
Mailing Address - Phone:252-535-8861
Mailing Address - Fax:
Practice Address - Street 1:205 SMITH CHURCH ROAD
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-4914
Practice Address - Country:US
Practice Address - Phone:252-535-8011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2009-00248207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200909290CMedicaid
01065157AOtherMD LICENCE