DR. NDIDI EUGENE MADU D.O. NPI 1457587842

NPI Information

  • NPI: 1457587842
  • Provider Name: DR. NDIDI EUGENE MADU, D.O.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1815 HIGHWAY 138 SE STE 800
    CONYERS, GA
    ZIP 30013
  • Phone: (770) 929-0404

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NPI Details

DR. Ndidi Eugene Madu, D.O. is a family medicine in Conyers, GA with 19 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Ndidi Eugene Madu, D.O. NPI is 1457587842. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Graduation Year:2007

The provider's business location address is:

1815 HIGHWAY 138 SE STE 800
CONYERS, GA
ZIP 30013-098
Phone: (770) 929-0404
Fax: (770) 929-0540

The NPI 1457587842 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/31/2009 and was last updated on 7/16/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine65703GEORGIAYes
2207Q00000XFamily Medicine065703GEORGIANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1003113173AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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