Basic Information
| Provider Information | |||||||||
| NPI: | 1821231432 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OFODILE | ||||||||
| FirstName: | CHINYELU | ||||||||
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| Credential: | D.O, | ||||||||
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| Mailing Information | |||||||||
| Address1: | 539 N WESTOVER BLVD | ||||||||
| Address2: | APT 1622 | ||||||||
| City: | ALBANY | ||||||||
| State: | GA | ||||||||
| PostalCode: | 317071951 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4045658825 | ||||||||
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| Practice Location | |||||||||
| Address1: | 425 W. THIRD AVENUE | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | ALBANY | ||||||||
| State: | GA | ||||||||
| PostalCode: | 31701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2293125222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2009 | ||||||||
| LastUpdateDate: | 01/07/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 67859 | GA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.