Provider Demographics
NPI:1780690222
Name:AZODO, UCHENDU (MD)
Entity Type:Individual
Prefix:
First Name:UCHENDU
Middle Name:
Last Name:AZODO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3900 ST FRANCIS WAY
Mailing Address - Street 2:SUITE 215
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-4925
Mailing Address - Country:US
Mailing Address - Phone:765-446-4819
Mailing Address - Fax:765-446-4859
Practice Address - Street 1:1701 S CREASY LN
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-4972
Practice Address - Country:US
Practice Address - Phone:765-446-4819
Practice Address - Fax:765-446-4859
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01070488B2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology