Provider Demographics
NPI:1811317886
Name:MADUBUONWU, PAUL NWEZE (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:NWEZE
Last Name:MADUBUONWU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PAUL
Other - Middle Name:NWEZE
Other - Last Name:MADUBUONWU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:501 HOLIDAY DRIVE
Mailing Address - Street 2:FOSTER PLAZA 4
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220
Mailing Address - Country:US
Mailing Address - Phone:662-745-6611
Mailing Address - Fax:662-745-9994
Practice Address - Street 1:4 FOSTER PLZ
Practice Address - Street 2:501 HOLIDAY DRIVE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-2749
Practice Address - Country:US
Practice Address - Phone:662-745-6611
Practice Address - Fax:662-745-9994
Is Sole Proprietor?:No
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS900-L207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine