Provider Demographics
NPI:1053792481
Name:NWACHUKU, ENYINNA L (MD)
Entity type:Individual
Prefix:
First Name:ENYINNA
Middle Name:L
Last Name:NWACHUKU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:762 S CLEVELAND-MASSILLON ROAD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333
Mailing Address - Country:US
Mailing Address - Phone:330-665-4100
Mailing Address - Fax:
Practice Address - Street 1:200 LOTHROP ST
Practice Address - Street 2:SUITE B-400
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2536
Practice Address - Country:US
Practice Address - Phone:412-647-6777
Practice Address - Fax:412-647-6483
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD478077207T00000X
PAMT208531390200000X
OH35.146353207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program