Provider Demographics
NPI:1689806333
Name:EMODI, CHUKA MICHAEL
Entity Type:Individual
Prefix:
First Name:CHUKA
Middle Name:MICHAEL
Last Name:EMODI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 SOUTHERLAND ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-2322
Mailing Address - Country:US
Mailing Address - Phone:919-730-8370
Mailing Address - Fax:
Practice Address - Street 1:422 SOUTHERLAND ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-2322
Practice Address - Country:US
Practice Address - Phone:919-730-8370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator