Provider Demographics
NPI:1982859468
Name:NNOROM, CHUKWUMA CHINEDU (MD)
Entity Type:Individual
Prefix:DR
First Name:CHUKWUMA
Middle Name:CHINEDU
Last Name:NNOROM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CHIMA
Other - Middle Name:CHINEDU
Other - Last Name:NNOROM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:502-588-0329
Mailing Address - Fax:502-588-0326
Practice Address - Street 1:601 W 2ND ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-2317
Practice Address - Country:US
Practice Address - Phone:812-353-9852
Practice Address - Fax:812-353-9278
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01065762A208000000X
KY483042080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics