Provider Demographics
NPI:1396862900
Name:CHUKWUANI, OKWUDILI FRANCIS (MD)
Entity type:Individual
Prefix:DR
First Name:OKWUDILI
Middle Name:FRANCIS
Last Name:CHUKWUANI
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 1:1201 GRAMPIAN BLVD
Mailing Address - Street 2:PO BOX 3127
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-0127
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:777 RURAL AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3145
Practice Address - Country:US
Practice Address - Phone:570-321-3165
Practice Address - Fax:570-321-3166
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01062713A208600000X, 208G00000X
PAMD433671208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2060961OtherHIGHMARK BLUE SHIELD
PA1021761040001Medicaid
PA1021761040001Medicaid
PA2060961OtherHIGHMARK BLUE SHIELD