Provider Demographics
NPI:1245313253
Name:OBASI, CHINYERE N (MD)
Entity type:Individual
Prefix:
First Name:CHINYERE
Middle Name:N
Last Name:OBASI
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 1:3219 CENTRAL AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-2949
Mailing Address - Country:US
Mailing Address - Phone:308-865-2370
Mailing Address - Fax:
Practice Address - Street 1:3219 CENTRAL AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-2949
Practice Address - Country:US
Practice Address - Phone:308-865-2370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67901207T00000X
NE24296207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PENDINGOtherMN BCBS
PENDINGOtherPREFERREDONE
PENDINGOtherMEDICA
PENDINGOtherND BCBS
NDPENDINGMedicaid
PENDINGOtherHEALTHPARTNERS
PENDINGOtherHEALTHPARTNERS
PENDINGOtherMEDICA