Provider Demographics
NPI:1619294295
Name:UKPEDE, FREEBIE OVWE (RT)
Entity Type:Individual
Prefix:
First Name:FREEBIE
Middle Name:OVWE
Last Name:UKPEDE
Suffix:
Gender:F
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 ROCK QUARRY RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-5029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1365 ROCK QUARRY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-5029
Practice Address - Country:US
Practice Address - Phone:678-284-6314
Practice Address - Fax:678-284-6282
Is Sole Proprietor?:No
Enumeration Date:2010-04-22
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography
No2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging