Provider Demographics
NPI:1821231432
Name:OFODILE, CHINYELU (DO,)
Entity type:Individual
Prefix:
First Name:CHINYELU
Middle Name:
Last Name:OFODILE
Suffix:
Gender:F
Credentials:DO,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 N WESTOVER BLVD
Mailing Address - Street 2:APT 1622
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-1951
Mailing Address - Country:US
Mailing Address - Phone:404-565-8825
Mailing Address - Fax:
Practice Address - Street 1:425 W. THIRD AVENUE
Practice Address - Street 2:SUITE 500
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701
Practice Address - Country:US
Practice Address - Phone:229-312-5222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-13
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA67859208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist