Provider Demographics
NPI:1235433707
Name:NWANONYIRI, IKE CHIDI (MD)
Entity type:Individual
Prefix:DR
First Name:IKE
Middle Name:CHIDI
Last Name:NWANONYIRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 744786
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-4786
Mailing Address - Country:US
Mailing Address - Phone:704-834-2450
Mailing Address - Fax:704-671-5331
Practice Address - Street 1:1381 E GARRISON BLVD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-5127
Practice Address - Country:US
Practice Address - Phone:704-861-2273
Practice Address - Fax:704-864-6336
Is Sole Proprietor?:No
Enumeration Date:2010-12-27
Last Update Date:2025-07-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2022-02229207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine