Provider Demographics
NPI:1699663583
Name:NWANNUNU, UGONNA
Entity type:Individual
Prefix:
First Name:UGONNA
Middle Name:
Last Name:NWANNUNU
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1676 MARYLAND AVE NE APT 569E
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-7730
Mailing Address - Country:US
Mailing Address - Phone:219-796-6008
Mailing Address - Fax:
Practice Address - Street 1:1676 MARYLAND AVE NE APT 569E
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-7730
Practice Address - Country:US
Practice Address - Phone:219-796-6008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program