Provider Demographics
NPI:1720234016
Name:NWAOGWUGWU, UCHEOMA D (MD)
Entity Type:Individual
Prefix:DR
First Name:UCHEOMA
Middle Name:D
Last Name:NWAOGWUGWU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:UCHEOMA
Other - Middle Name:D
Other - Last Name:NWAKANMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4700 MILLENIA BLVD STE 650
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-6013
Mailing Address - Country:US
Mailing Address - Phone:407-533-6836
Mailing Address - Fax:407-232-9316
Practice Address - Street 1:11978 WESTHEIMER RD STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-6669
Practice Address - Country:US
Practice Address - Phone:346-275-6750
Practice Address - Fax:877-542-6970
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262980207R00000X
CT050970207R00000X
390200000X
TXQ5236207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3619934Medicaid