Provider Demographics
NPI:1275780199
Name:NWAEDOZIE, AZUKA IFEYINWA (DPM)
Entity type:Individual
Prefix:DR
First Name:AZUKA
Middle Name:IFEYINWA
Last Name:NWAEDOZIE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:4129 INTEGRITY WAY
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-2620
Mailing Address - Country:US
Mailing Address - Phone:678-489-6589
Mailing Address - Fax:678-489-6522
Practice Address - Street 1:101 JOHN MADDOX DR NW STE A
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1481
Practice Address - Country:US
Practice Address - Phone:678-489-6589
Practice Address - Fax:678-489-6522
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-21
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY006294213EP1101X
GAPOD001142213EP1101X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine