Provider Demographics
NPI:1760621981
Name:UZOMA BEN GBULIE MD PLLC
Entity Type:Organization
Organization Name:UZOMA BEN GBULIE MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:UZOMA
Authorized Official - Middle Name:BEN
Authorized Official - Last Name:GBULIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-393-9677
Mailing Address - Street 1:4 JOYCETON TER
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1334
Mailing Address - Country:US
Mailing Address - Phone:240-393-9677
Mailing Address - Fax:
Practice Address - Street 1:2041 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20060-0001
Practice Address - Country:US
Practice Address - Phone:202-865-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD035694208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty