Provider Demographics
NPI:1619237773
Name:UGWUEGBULEM, EJOH EVELINE
Entity Type:Individual
Prefix:
First Name:EJOH
Middle Name:EVELINE
Last Name:UGWUEGBULEM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3506 HUBBARD RD APT 103
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-2072
Mailing Address - Country:US
Mailing Address - Phone:240-438-8234
Mailing Address - Fax:
Practice Address - Street 1:3506 HUBBARD RD APT 103
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-2072
Practice Address - Country:US
Practice Address - Phone:240-438-8234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide