Provider Demographics
NPI:1508064213
Name:ANDY, UDUAK UMOH (MD)
Entity Type:Individual
Prefix:
First Name:UDUAK
Middle Name:UMOH
Last Name:ANDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:UDAK
Other - Middle Name:E
Other - Last Name:UMOH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-6130
Mailing Address - Country:US
Mailing Address - Phone:215-829-2345
Mailing Address - Fax:215-829-3365
Practice Address - Street 1:800 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6130
Practice Address - Country:US
Practice Address - Phone:215-829-2345
Practice Address - Fax:215-829-3365
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD445152207V00000X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology