Provider Demographics
NPI:1982312542
Name:NNEAMAKA NWUBAH LLC
Entity Type:Organization
Organization Name:NNEAMAKA NWUBAH LLC
Other - Org Name:AMAKA AESTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:NNEAMAKA
Authorized Official - Middle Name:AGOCHUKWU
Authorized Official - Last Name:NWUBAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-813-9655
Mailing Address - Street 1:424 CHURCH ST STE 2000
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-3304
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5409 MARYLAND WAY STE 115
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-1076
Practice Address - Country:US
Practice Address - Phone:615-804-6113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-11
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ079008Medicaid