Provider Demographics
NPI:1689129967
Name:ONWE, IFEANYICHUKWU ANTHONY-CLARET (MD)
Entity Type:Individual
Prefix:DR
First Name:IFEANYICHUKWU
Middle Name:ANTHONY-CLARET
Last Name:ONWE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:IFEANYI
Other - Middle Name:
Other - Last Name:ONWE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:245 N 15TH ST
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1101
Mailing Address - Country:US
Mailing Address - Phone:215-762-7916
Mailing Address - Fax:215-762-7765
Practice Address - Street 1:245 N 15TH ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1101
Practice Address - Country:US
Practice Address - Phone:215-762-7916
Practice Address - Fax:215-762-7765
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT212275207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine