Provider Demographics
NPI:1184634446
Name:EMEJURU, OGUBUIKE (MD)
Entity Type:Individual
Prefix:MR
First Name:OGUBUIKE
Middle Name:
Last Name:EMEJURU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 KINGSBOROUGH SQ STE A
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4988
Mailing Address - Country:US
Mailing Address - Phone:757-436-2300
Mailing Address - Fax:757-436-2303
Practice Address - Street 1:680 KINGSBOROUGH SQ STE A
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4988
Practice Address - Country:US
Practice Address - Phone:757-436-2300
Practice Address - Fax:757-436-2303
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040592208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006713173Medicaid