Provider Demographics
NPI:1821595646
Name:CHOKUBA-AZUM, CATHERINE IFEYINWA (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:IFEYINWA
Last Name:CHOKUBA-AZUM
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 1:5745 STERLING OAKS DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8271
Mailing Address - Country:US
Mailing Address - Phone:423-454-9328
Mailing Address - Fax:
Practice Address - Street 1:5745 STERLING OAKS DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8271
Practice Address - Country:US
Practice Address - Phone:423-454-9328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TN64095207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program