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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | BCBS | 000000772101 | 01 |
IN | 200962220 | 05 | |
IN | R.R. MEDICARE | P00803485 | 01 |
IN | ANTHEM | 000000635990 | 01 |
Street Address |
2200 RANDALLIA DR. |
City | FORT WAYNE |
State | IN |
Zip Code | 46805-4738 |
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 |
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 Code | 207RC0200X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Critical Care Medicine |
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. |
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 |
City | FORT WAYNE |
Zip Code | 46805 |
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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.