Provider Demographics
NPI:1104677962
Name:CHIBUIKE BRUNO OBIOHA LLC
Entity type:Organization
Organization Name:CHIBUIKE BRUNO OBIOHA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHIBUIKE
Authorized Official - Middle Name:BRUNO
Authorized Official - Last Name:OBIOHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-692-2002
Mailing Address - Street 1:4834 SOCIALVILLE FOSTER RD STE 10
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6805
Mailing Address - Country:US
Mailing Address - Phone:615-692-2002
Mailing Address - Fax:
Practice Address - Street 1:4834 SOCIALVILLE FOSTER RD STE 10
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6805
Practice Address - Country:US
Practice Address - Phone:615-692-2002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-29
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty