Provider Demographics
NPI:1679734453
Name:NWAUBANI, UZOMA KELECHI (MD)
Entity Type:Individual
Prefix:DR
First Name:UZOMA
Middle Name:KELECHI
Last Name:NWAUBANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9580 N US HIGHWAY 301
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34785-8772
Mailing Address - Country:US
Mailing Address - Phone:352-633-0703
Mailing Address - Fax:352-399-2168
Practice Address - Street 1:9580 N US HIGHWAY 301
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:FL
Practice Address - Zip Code:34785-8772
Practice Address - Country:US
Practice Address - Phone:352-633-0703
Practice Address - Fax:352-399-2168
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08394000207V00000X
FLME105721207V00000X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002182700Medicaid
FL002182700Medicaid
FL6793110001Medicare NSC