Provider Demographics
NPI:1528756616
Name:CHUKWUKA, COLUMBA CHUKWUBUIKEM (MD)
Entity type:Individual
Prefix:
First Name:COLUMBA
Middle Name:CHUKWUBUIKEM
Last Name:CHUKWUKA
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 1:7301 ROGERS AVENUE
Mailing Address - Street 2:MERCY HOSPITAL FORT SMITH GRADUATE MEDICAL EDUCATION
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903
Mailing Address - Country:US
Mailing Address - Phone:479-573-3838
Mailing Address - Fax:
Practice Address - Street 1:7301 ROGERS AVENUE
Practice Address - Street 2:MERCY HOSPITAL FORT SMITH GRADUATE MEDICAL EDUCATION
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903
Practice Address - Country:US
Practice Address - Phone:479-573-3838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program