Basic Information
| Provider Information | |||||||||
| NPI: | 1689823395 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NWELUE | ||||||||
| FirstName: | IJEOMA | ||||||||
| MiddleName: | CAROL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11125 DUNN RD STE 2427 | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631366132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3146953556 | ||||||||
| FaxNumber: | 3146535648 | ||||||||
| Practice Location | |||||||||
| Address1: | 11125 DUNN RD STE 2427 | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 63136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3146953556 | ||||||||
| FaxNumber: | 3146535648 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2008 | ||||||||
| LastUpdateDate: | 07/18/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 000000000 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 2018015467 | MO | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.