Provider Demographics
NPI:1861453193
Name:OKPALEKE, ANDREW CHIDI (MD, MPH)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:CHIDI
Last Name:OKPALEKE
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 148576
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214
Mailing Address - Country:US
Mailing Address - Phone:615-232-7162
Mailing Address - Fax:615-232-7308
Practice Address - Street 1:500 MAPLELEAF DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210
Practice Address - Country:US
Practice Address - Phone:615-232-7162
Practice Address - Fax:615-232-7308
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD14656207R00000X, 208VP0000X
TNMD0000014656207R00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN472OtherPAIN CLINIC CERTIFICATION NUMBER
TN1031I17295OtherMEDICARE PROVIDER NUMBER (PTAN)
TN1528387Medicaid
TN1031I17295OtherMEDICARE PROVIDER NUMBER (PTAN)
TNF04939Medicare UPIN