Provider Demographics
NPI:1770110165
Name:NNADI, CHISOM (MD)
Entity type:Individual
Prefix:DR
First Name:CHISOM
Middle Name:
Last Name:NNADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CHISOM CHUKWUEMEKA
Other - Middle Name:BRIAN
Other - Last Name:NNADI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:160 NW 170TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5576
Mailing Address - Country:US
Mailing Address - Phone:305-651-1100
Mailing Address - Fax:
Practice Address - Street 1:160 NW 170TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33169-5521
Practice Address - Country:US
Practice Address - Phone:305-651-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME166766207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine