Provider Demographics
NPI:1396078549
Name:IZEDIUNO, VINCENT AMAECHI (MD, MRCPSYCH)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:AMAECHI
Last Name:IZEDIUNO
Suffix:
Gender:M
Credentials:MD, MRCPSYCH
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:600 GREEN VALLEY RD STE 208
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7722
Mailing Address - Country:US
Mailing Address - Phone:336-549-8334
Mailing Address - Fax:336-860-1981
Practice Address - Street 1:600 GREEN VALLEY RD STE 208
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7722
Practice Address - Country:US
Practice Address - Phone:336-549-8334
Practice Address - Fax:336-860-1981
Is Sole Proprietor?:No
Enumeration Date:2009-09-04
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH570158932084P0800X
CT673032084P0800X
NC2016-021792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry