| Doctor Name: | CHINELO OFOMA |
| NPI Number: | 1093176729 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 20099 |
| Business Practice Address: | 704 Gold Hill Rd Suite 207 Fort Mill, SC - 297158906 |
| Business Phone Number: | 8038025900 |
| Business Fax Number: | |
| Mailing Address: | 177 Bromley Village Dr, FORT MILL |
| State: | SC |
| Postal Code: | 297087044 |
| Phone Number: | 7322163522 |
| Fax Number: | |
| NPI Enumeration Date: | 03/08/2016 |
| NPI Last Update Date: | 03/29/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 20099 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |