Provider Demographics
NPI:1629519376
Name:AHUAMA-JONAS, CHIZARA
Entity Type:Individual
Prefix:
First Name:CHIZARA
Middle Name:
Last Name:AHUAMA-JONAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 BLOEDEL RESERVE WAY
Mailing Address - Street 2:APT 203
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-7352
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:407 BLOEDEL RESERVE WAY
Practice Address - Street 2:APT 203
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-7352
Practice Address - Country:US
Practice Address - Phone:706-721-3546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program