Individual provider Active NPI

Michael Chinedu Nwude, M.D., MPH

  • Family Medicine Physician
  • Columbia, SC
National Provider Identifier
1477547032
Registry record updated Apr 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A76605 Issued in CA
Practice address
3209 Colonial Dr
Columbia, SC 29203-6930
Phone
(310) 308-6999
NPI assigned
Sep 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A76605 CA Primary

Addresses

Primary practice location

3209 Colonial Dr
Columbia, SC 29203-6930

Mailing address

PO Box 21701
Columbia, SC 29221-1701
Phone (310) 308-6999

Other identifiers 1

IdentifierTypeStateIssuer
00A766050MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A76605CAMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241049600000",
    "number": "1477547032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21701",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292211701",
            "telephone_number": "310-308-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 COLONIAL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036930",
            "telephone_number": "310-308-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWUDE",
        "first_name": "MICHAEL",
        "middle_name": "CHINEDU",
        "credential": "M.D., MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2009-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A76605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A766050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.