Provider Demographics
NPI:1568965390
Name:IKE, UCHE (MD)
Entity Type:Individual
Prefix:DR
First Name:UCHE
Middle Name:
Last Name:IKE
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 1:3112 W WARREN BLVD APT 2E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-1965
Mailing Address - Country:US
Mailing Address - Phone:910-366-3970
Mailing Address - Fax:
Practice Address - Street 1:930 MAR WALT DR
Practice Address - Street 2:UNIT C
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547
Practice Address - Country:US
Practice Address - Phone:850-226-6801
Practice Address - Fax:877-413-5104
Is Sole Proprietor?:No
Enumeration Date:2018-03-18
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME155245207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology