Provider Demographics
NPI:1225522055
Name:MADUBUIBE, CHIDINMA EZE
Entity type:Individual
Prefix:MRS
First Name:CHIDINMA
Middle Name:EZE
Last Name:MADUBUIBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4341 1ST ST NE APT 4
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-7476
Mailing Address - Country:US
Mailing Address - Phone:202-677-2659
Mailing Address - Fax:
Practice Address - Street 1:4341 1ST ST NE APT 4
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-7476
Practice Address - Country:US
Practice Address - Phone:202-677-2659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13730374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide