Provider Demographics
NPI:1336191048
Name:IGHADE, ANDREW ELUONYE (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:ELUONYE
Last Name:IGHADE
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 1:2540 W ARROWOOD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-6198
Mailing Address - Country:US
Mailing Address - Phone:704-588-0232
Mailing Address - Fax:704-588-0445
Practice Address - Street 1:2540 WEST ARROWOOD RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273
Practice Address - Country:US
Practice Address - Phone:704-588-0232
Practice Address - Fax:704-588-0232
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200201480208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC18913257Medicaid
NC18913257Medicaid