Provider Demographics
NPI:1942487251
Name:ONYEAGOCHA, CHUKWUMA ONWUMERE (MD)
Entity Type:Individual
Prefix:
First Name:CHUKWUMA
Middle Name:ONWUMERE
Last Name:ONYEAGOCHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3495 HACKS CROSS RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-8803
Mailing Address - Country:US
Mailing Address - Phone:901-526-7444
Mailing Address - Fax:901-526-2606
Practice Address - Street 1:3495 HACKS CROSS RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125
Practice Address - Country:US
Practice Address - Phone:901-526-7444
Practice Address - Fax:901-526-0791
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002694207ZP0101X
TN46700207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology