Provider Demographics
NPI:1639179211
Name:AMU, CHUKWUDI BATO (MD)
Entity Type:Individual
Prefix:
First Name:CHUKWUDI
Middle Name:BATO
Last Name:AMU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5526 OLD NATIONAL HWY
Mailing Address - Street 2:SUITE B, BLDG J
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-3249
Mailing Address - Country:US
Mailing Address - Phone:404-766-6001
Mailing Address - Fax:678-904-2769
Practice Address - Street 1:5526 OLD NATIONAL HWY
Practice Address - Street 2:SUITE B, BLDG J
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-3249
Practice Address - Country:US
Practice Address - Phone:404-766-6001
Practice Address - Fax:678-904-2769
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
GA026967207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA582278915OtherTAX ID
GA00436543BMedicaid
GAE85899Medicare UPIN
GA582278915OtherTAX ID