Provider Demographics
NPI:1205457538
Name:CHINEDOZI, IFEANYICHUKWU DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:IFEANYICHUKWU
Middle Name:DAVID
Last Name:CHINEDOZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:IFEANYI
Other - Middle Name:
Other - Last Name:CHINEDOZI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:22 S GREENE ST # S8B02
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1590
Mailing Address - Country:US
Mailing Address - Phone:423-676-2763
Mailing Address - Fax:
Practice Address - Street 1:22 S GREENE ST # S8B02
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1590
Practice Address - Country:US
Practice Address - Phone:423-676-2763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program