Provider Demographics
NPI:1912288523
Name:OBI, CHUKWUMA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHUKWUMA
Middle Name:
Last Name:OBI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-2019
Mailing Address - Country:US
Mailing Address - Phone:617-254-0104
Mailing Address - Fax:617-562-6089
Practice Address - Street 1:465 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-2019
Practice Address - Country:US
Practice Address - Phone:617-254-0104
Practice Address - Fax:617-562-6089
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA27622183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist