Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. INNOCENT CHUKWUMA EZENWA, MD
ActiveDR. INNOCENT CHUKWUMA EZENWA, MD is a Sports Medicine (IM) healthcare provider located in SPARKS, Nevada. NPI 1699891192 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (IM) · SPARKS, NV
Registration Details
- NPI Number
- 1699891192
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 22, 2007 (19.436210143157 yrs)
- Last Updated
- Nov 5, 2021
- Licenses
-
042-0012250 (VT)16000 (NV)
Practice Information
- Address
-
2115 GREEN VISTA DR STE 101SPARKS, NV, 894318516Browse NV providers · Browse ZIP 89431
- Phone
- 7755574900
- Fax
- 7755577240
- Primary Specialty
-
Sports Medicine (IM)
207RS0012X
- Additional Specialty
- Sports Medicine (IM)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.