Provider Demographics
NPI:1124108303
Name:ANENE, CHARLES AZUBUIKE (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:AZUBUIKE
Last Name:ANENE
Suffix:
Gender:
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:PO BOX 63362
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28263-3362
Mailing Address - Country:US
Mailing Address - Phone:800-782-6945
Mailing Address - Fax:
Practice Address - Street 1:300 W 27TH ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-3075
Practice Address - Country:US
Practice Address - Phone:910-671-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066370L208G00000X
NJ25MA06518800208G00000X
NC2016-02042208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
2372299OtherAETNA
8438706OtherNJ MEDICAL ASSISTANCE
0071575000OtherIBC
0071575000OtherAMERIHEALTH
0152107202OtherAMERICHOICE
1125019OtherKEYSTONE MERCY HEALTH PLA
019033OtherHIGHMARK
PA001820720001Medicaid
NJ012207OtherMEDICARE
330005393OtherRAILROAD MEDICARE
8211867002OtherCIGNA
0152107202OtherAMERICHOICE
016464Medicare ID - Type Unspecified