Provider Demographics
NPI:1992704266
Name:CHINWAH, HEZEKIAH UBOCHI (MD)
Entity type:Individual
Prefix:DR
First Name:HEZEKIAH
Middle Name:UBOCHI
Last Name:CHINWAH
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 63423
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85082-3423
Mailing Address - Country:US
Mailing Address - Phone:480-892-2800
Mailing Address - Fax:480-982-1400
Practice Address - Street 1:4838 E BASELINE RD
Practice Address - Street 2:BLDG. 2 STE. 110
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4671
Practice Address - Country:US
Practice Address - Phone:480-892-2800
Practice Address - Fax:480-892-3258
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2013-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10456207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ236168Medicaid
AZ236168Medicaid
AZE80450Medicare UPIN
AZZ69445Medicare PIN
AZZ11WCKGK08Medicare PIN