Provider Demographics
NPI:1073954368
Name:AZUEWAH, UGO OLUCHI
Entity Type:Individual
Prefix:MS
First Name:UGO
Middle Name:OLUCHI
Last Name:AZUEWAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:UGO
Other - Middle Name:OLUCHI
Other - Last Name:AZUEWAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:1314 IRON OAK CV
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-1868
Mailing Address - Country:US
Mailing Address - Phone:240-602-6005
Mailing Address - Fax:
Practice Address - Street 1:951 DUNLORING CT
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-5780
Practice Address - Country:US
Practice Address - Phone:240-602-6005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR221426363LP0808X
DCHHA7365251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health