Provider Demographics
NPI:1629414339
Name:OKOROAFOR-RIDGWAY, UGOCHI (MD)
Entity Type:Individual
Prefix:
First Name:UGOCHI
Middle Name:
Last Name:OKOROAFOR-RIDGWAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:UGOCHI
Other - Middle Name:
Other - Last Name:OKOROAFOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:9480 MAIN ST # 1129
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4032
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8500 EXECUTIVE PARK AVE STE 310
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2249
Practice Address - Country:US
Practice Address - Phone:703-894-0695
Practice Address - Fax:800-770-6204
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101269435207XS0106X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery