Provider Demographics
NPI:1225733165
Name:EWUZIE, KENECHUKWU NWACHUKWU
Entity Type:Individual
Prefix:MR
First Name:KENECHUKWU
Middle Name:NWACHUKWU
Last Name:EWUZIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 28TH ST SE APT 3
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-3647
Mailing Address - Country:US
Mailing Address - Phone:484-506-7608
Mailing Address - Fax:
Practice Address - Street 1:1427 GOOD HOPE RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5614
Practice Address - Country:US
Practice Address - Phone:202-836-4841
Practice Address - Fax:202-836-4842
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-31
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator