Provider Demographics
NPI:1003602103
Name:EZIDIEGWU, CHIDINMA THERESA (MD)
Entity type:Individual
Prefix:MRS
First Name:CHIDINMA
Middle Name:THERESA
Last Name:EZIDIEGWU
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:CHIDINMA
Other - Middle Name:THERESA
Other - Last Name:CHUKWULEBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:AIKEN REGIONAL MEDICAL CENTERS
Mailing Address - Street 2:302 UNIVERSITY PARKWAY
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801
Mailing Address - Country:US
Mailing Address - Phone:803-842-0436
Mailing Address - Fax:
Practice Address - Street 1:AIKEN REGIONAL MEDICAL CENTERS
Practice Address - Street 2:302 UNIVERSITY PARKWAY
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801
Practice Address - Country:US
Practice Address - Phone:803-842-0436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program