Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2016-02042 | NC |
Y | 208600000X | Surgeon | 2016-02042 | NC |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 25MA06518800 | NJ |
N | 208G00000X | Cardiothoracic Vascular Surgeon | MD066370L | PA |
NPI | 1124108303 |
---|---|
Provider Name | Charles Azubuike Anene |
First Address | Charlotte, NC 28263-3362 |
Second Address | Lumberton, NC 28358-3075 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 26/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001820720001 | (05) | PA |
0071575000 | AMERIHEALTH (01) | |
0071575000 | IBC (01) | |
012207 | MEDICARE (01) | NJ |
0152107202 | AMERICHOICE (01) | |
019033 | HIGHMARK (01) | |
1125019 | KEYSTONE MERCY HEALTH PLA (01) | |
2372299 | AETNA (01) | |
330005393 | RAILROAD MEDICARE (01) | |
8211867002 | CIGNA (01) | |
8438706 | NJ MEDICAL ASSISTANCE (01) | |
E82186 | (02) |