Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | LP04340 | RI |
Y | 208600000X | Surgeon | LP04340 | RI |
NPI | 1013409846 |
---|---|
Provider Name | Chibueze Nwaiwu |
First Address | Providence, RI 02903-4923 |
Second Address | Providence, RI 02903-4923 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2018 |
Last Update Date | 06/06/2018 |