Provider Demographics
NPI:1568234029
Name:EGUREFA, UFUOMA ONOME
Entity Type:Individual
Prefix:
First Name:UFUOMA
Middle Name:ONOME
Last Name:EGUREFA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:UFUOMA
Other - Middle Name:ONOME
Other - Last Name:ANIOGOH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10001 GRAYSTONE DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-4744
Mailing Address - Country:US
Mailing Address - Phone:571-201-2007
Mailing Address - Fax:
Practice Address - Street 1:901 HARRY S TRUMAN DR N
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5477
Practice Address - Country:US
Practice Address - Phone:240-677-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNP1056469363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily