Provider Demographics
NPI:1689872756
Name:IJIOMA, NKECHINYERE N (MD)
Entity Type:Individual
Prefix:
First Name:NKECHINYERE
Middle Name:N
Last Name:IJIOMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NKECHI
Other - Middle Name:
Other - Last Name:IJEOMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MBBS
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-7677
Mailing Address - Fax:614-293-1456
Practice Address - Street 1:543 TAYLOR AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1278
Practice Address - Country:US
Practice Address - Phone:614-293-7677
Practice Address - Fax:614-293-1456
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.096956207RI0011X, 207RC0000X, 207R00000X
WI65020207RI0011X
MN57414207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine