Provider Demographics
NPI:1881910115
Name:WAKWE, WALTER CHIKELUEZE (MD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:CHIKELUEZE
Last Name:WAKWE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10401 W. THUNDERBIRD BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351
Mailing Address - Country:US
Mailing Address - Phone:623-977-7211
Mailing Address - Fax:480-256-3682
Practice Address - Street 1:10401 W. THUNDERBIRD BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351
Practice Address - Country:US
Practice Address - Phone:623-977-7211
Practice Address - Fax:480-256-3682
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ60750208G00000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty