Provider Demographics
NPI:1396981940
Name:NWACHUKU, CHINENYE OKEZIE (MD)
Entity type:Individual
Prefix:DR
First Name:CHINENYE
Middle Name:OKEZIE
Last Name:NWACHUKU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:PRISCILLA PAYNE HURD PAVILLION, 2ND FLOOR
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-526-1735
Mailing Address - Fax:484-526-2429
Practice Address - Street 1:801 OSTRUM ST
Practice Address - Street 2:PRISCILLA PAYNE HURD PAVILLION, 2ND FLOOR
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1000
Practice Address - Country:US
Practice Address - Phone:484-526-1735
Practice Address - Fax:484-526-2429
Is Sole Proprietor?:No
Enumeration Date:2009-01-05
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY247543207X00000X
PAMD440925207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102577364Medicaid
PA214970Medicare PIN