Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 5101016657 | MI |
NPI | 1033233259 |
---|---|
Provider Name | Dr. Chijioke Chika Nwagwu |
First Address | Chicago, IL 60677-6006 |
Second Address | Novi, MI 48377 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 21/01/2019 |