Provider Demographics
NPI:1598069270
Name:IWELU, EMAKE ALICE (MD)
Entity Type:Individual
Prefix:DR
First Name:EMAKE
Middle Name:ALICE
Last Name:IWELU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EMAKE
Other - Middle Name:ALICE
Other - Last Name:ONWUDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1811 CAMBRIA LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5766
Mailing Address - Country:US
Mailing Address - Phone:832-283-4576
Mailing Address - Fax:
Practice Address - Street 1:1811 CAMBRIA LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-5766
Practice Address - Country:US
Practice Address - Phone:832-283-4576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7627010-1205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine