Provider Demographics
NPI:1851641575
Name:NDUBISI, UCHENNA UZOMA
Entity Type:Individual
Prefix:
First Name:UCHENNA
Middle Name:UZOMA
Last Name:NDUBISI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10750 COLUMBIA PIKE
Mailing Address - Street 2:SUITE 401B
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4457
Mailing Address - Country:US
Mailing Address - Phone:301-592-1500
Mailing Address - Fax:301-592-1506
Practice Address - Street 1:4321 HARTWICK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-3210
Practice Address - Country:US
Practice Address - Phone:301-277-6616
Practice Address - Fax:301-277-6618
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD241802251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic