Provider Demographics
NPI:1801836325
Name:ONUORAH UMEH, MD, PC
Entity Type:Organization
Organization Name:ONUORAH UMEH, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ONUORAH
Authorized Official - Middle Name:IKE
Authorized Official - Last Name:UMEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-382-1040
Mailing Address - Street 1:4237 BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4411
Mailing Address - Country:US
Mailing Address - Phone:215-382-1040
Mailing Address - Fax:215-382-1047
Practice Address - Street 1:4237 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4411
Practice Address - Country:US
Practice Address - Phone:215-382-1040
Practice Address - Fax:215-382-1047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039262L261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC31968Medicare UPIN
PA149817Medicare ID - Type Unspecified