Provider Demographics
NPI:1629188636
Name:UCHENDU, UCHENNA SCHOLASTICA (MD)
Entity Type:Individual
Prefix:DR
First Name:UCHENNA
Middle Name:SCHOLASTICA
Last Name:UCHENDU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:UCHENNA
Other - Middle Name:SCHOLASTICA
Other - Last Name:OTORGBOLU / OTOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 6634
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75505-6634
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:910 REALTOR AVE
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854-1020
Practice Address - Country:US
Practice Address - Phone:870-216-2242
Practice Address - Fax:870-216-2583
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine