DR. CHUCK G NWAKANMA


Address: 2200 Randallia Dr., Fort Wayne, IN 46805-4738
Phone: 2603736315

DR. CHUCK G NWAKANMA (NPI# 1417984063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417984063
Entity Type Individual
Full Name DR. CHUCK G NWAKANMA
Other Name DR. CHUKWUEMEKA G NWAKANMA
Practice Address 2200 Randallia Dr.
Fort Wayne
IN 46805-4738
Mailing Address 1234 E. Dupont Rd.
Suite 3
Fort Wayne
IN 46825-1545
Practice Telephone 2603736315
Practice Fax Number 2603736348
Mailing Telephone 2603739728
Mailing Fax Number 2603739740
Enumeration Date 2006-06-27
Last Update Date 2012-10-18
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RC0200X Internal Medicine
Specialization: Critical Care Medicine
01067430A IN Allopathic & Osteopathic Physicians
N 207RC0200X Internal Medicine
Specialization: Critical Care Medicine
036-104042 IL Allopathic & Osteopathic Physicians
N 207RC0200X Internal Medicine
Specialization: Critical Care Medicine
2006015249 MO Allopathic & Osteopathic Physicians
N 207RC0200X Internal Medicine
Specialization: Critical Care Medicine
4301082608 MI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IN BCBS 000000772101 01
IN 200962220 05
IN R.R. MEDICARE P00803485 01
IN ANTHEM 000000635990 01

Office Location

Street Address 2200 RANDALLIA DR.
City FORT WAYNE
State IN
Zip Code 46805-4738

Providers in the same location

NPI Name Taxonomy Address Enumeration
1699175190 Nicole Ann Walter Physical Therapist 2200 Randallia Dr., Fort Wayne, IN 46805 2014-09-03
1588940761 Dawn Pauline Dunn Registered Nurse 2200 Randallia Dr., Fort Wayne, IN 46805-4638 2011-11-01
1376859967 Kathy L Wehrle Dietitian, Registered 2200 Randallia Dr., Fort Wayne, IN 46805-4763 2010-08-20
1538474515 Laurie B Patterson Dietitian, Registered 2200 Randallia Dr., Fort Wayne, IN 46805 2010-08-13
1407010564 Emily E Lierman Physician Assistant 2200 Randallia Dr., Fort Wayne, IN 46805-4638 2008-07-17
1578579793 Peter Benson So Internal Medicine 2200 Randallia Dr., Fort Wayne, IN 46805-4765 2006-07-31

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1619589546 Connor Gemlick Student in an Organized Health Care Education/Training Program 1918 Carew St., Fort Wayne, IN 46805 2020-08-21
1710464086 S.t.a.r. Care Services Clinic/Center 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 2018-07-19
1083122865 Noel Shafi Counselor 3010 East State Boulevard, Fort Wayne, IN 46805 2018-01-16
1063963627 Toni L Irby Specialist 3219 E State Blvd, Fort Wayne, IN 46805 2016-10-19
1639626211 Logan Schwerer Pharmacist 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 2016-09-01
1063817104 Michale Diane Rothgeb Physical Therapy Assistant 2200 Randollia Dr, Fort Wayne, IN 46805 2014-10-31
1124435789 Julia I. Mcfann Physical Therapist 2200 Randalia Dr, Fort Wayne, IN 46805 2014-07-16
1083036974 Capital Senior Living Properties 4, Inc. Assisted Living Facility 3320 East State Boulevard, Fort Wayne, IN 46805 2014-01-10
1356772396 Alexander James Medical Supply Durable Medical Equipment & Medical Supplies 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 2013-12-02
1043595689 Randy James Jennings Pharmacist 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 2011-10-14
Find all providers in zip 46805

Taxonomy Information

Taxonomy Code 207RC0200X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Critical Care Medicine

Taxonomy Definition

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1235481755 Dedrick K. Bowe Internal Medicine 800 Broadway Ste 204, Fort Wayne, IN 46802-2149 2012-10-08
1912032434 Brian Allen Youn Internal Medicine 821 S Scott Rd, Fort Wayne, IN 46814-9398 2007-02-23
1104874452 Srinivasan Devanathan Internal Medicine 8028 Carnegie Blvd., Suite 600, Fort Wayne, IN 46804-5790 2006-05-05
1457353591 Jean M Weaver Internal Medicine 11104 Parkview Circle Dr Ste 410, Fort Wayne, IN 46845-0025 2005-08-10
1194135939 Mohamed Mahfoud Internal Medicine 11109 Parkview Plaza Dr, Fort Wayne, IN 46845 2014-05-01
1508207713 Fabian Alexander Lemp Internal Medicine 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 2013-07-16
1093154635 Kevin Sun Internal Medicine 11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 2013-06-17
1184979882 Nikki Mo Wynn Internal Medicine 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 2012-07-18
1336400019 Krishna Sudhir Ayyagari Internal Medicine 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 2012-05-30
1730472945 Armais V. Akovbyan Internal Medicine 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 2011-05-20
Find all providers in FORT WAYNE

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City FORT WAYNE
Zip Code 46805

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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