Provider Demographics
NPI:1750649794
Name:UKAOMA, MOSES
Entity Type:Individual
Prefix:
First Name:MOSES
Middle Name:
Last Name:UKAOMA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 SIR MICHAEL PL
Mailing Address - Street 2:
Mailing Address - City:GLENARDEN
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1685
Mailing Address - Country:US
Mailing Address - Phone:301-312-3344
Mailing Address - Fax:
Practice Address - Street 1:955 LENFANT PLZ SW STE 985
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-6104
Practice Address - Country:US
Practice Address - Phone:202-282-3004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide