Provider Demographics
NPI:1013356401
Name:UWANDU, AMARACHI GRACE
Entity Type:Individual
Prefix:DR
First Name:AMARACHI
Middle Name:GRACE
Last Name:UWANDU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DUKE OF WINDSOR CT
Mailing Address - Street 2:APT 103
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-5399
Mailing Address - Country:US
Mailing Address - Phone:410-369-8233
Mailing Address - Fax:
Practice Address - Street 1:10 DUKE OF WINDSOR CT
Practice Address - Street 2:APT 103
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-5399
Practice Address - Country:US
Practice Address - Phone:410-369-8233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20946183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist