Provider Demographics
NPI:1689011322
Name:EZEKWE, CHIOMA KENECHUKWU (MD)
Entity Type:Individual
Prefix:DR
First Name:CHIOMA
Middle Name:KENECHUKWU
Last Name:EZEKWE
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 1:2929 E 6TH ST APT 154
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-4831
Mailing Address - Country:US
Mailing Address - Phone:814-853-9882
Mailing Address - Fax:
Practice Address - Street 1:2929 E 6TH ST APT 154
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-4831
Practice Address - Country:US
Practice Address - Phone:814-853-9882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ54464207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty