Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | DO034629 | DC |
N | 2081P2900X | Pain Medicine | 252614-1 | NY |
Y | 2081P2900X | Pain Medicine | H0077516 | MD |
NPI | 1184850505 |
---|---|
Provider Name | Adaku U. Nwachuku |
First Address | Clinton, MD 20735-1642 |
Second Address | Clinton, MD 20735-1642 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2009 |
Last Update Date | 26/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
451911 | MEDICARE PTAN (01) | DC |
451944 | MEDICARE PTAN (01) | MD |