Provider Demographics
NPI:1306919444
Name:NWOKEJI, EMMANUEL IGWEZE (MD)
Entity type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:IGWEZE
Last Name:NWOKEJI
Suffix:
Gender:M
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 613169
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38101-3169
Mailing Address - Country:US
Mailing Address - Phone:901-758-1675
Mailing Address - Fax:901-758-0434
Practice Address - Street 1:865 POPLAR
Practice Address - Street 2:MEMPHIS MENTAL HEALTH INSTITUTE
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104
Practice Address - Country:US
Practice Address - Phone:901-524-1200
Practice Address - Fax:901-524-5252
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000199172084P0800X
PAMD040640L2084P0800X
MOR3M022084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
E93897Medicare UPIN