Provider Demographics
NPI:1851686638
Name:UCHE, IJEOMA (MD, PHARMD)
Entity Type:Individual
Prefix:
First Name:IJEOMA
Middle Name:
Last Name:UCHE
Suffix:
Gender:F
Credentials:MD, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26224 N TATUM BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-7500
Mailing Address - Country:US
Mailing Address - Phone:480-882-7582
Mailing Address - Fax:480-563-7442
Practice Address - Street 1:26224 N TATUM BLVD STE 5
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-7500
Practice Address - Country:US
Practice Address - Phone:480-882-7582
Practice Address - Fax:480-563-7442
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA152328207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine