Provider Demographics
NPI:1891007969
Name:NWAIWU, PAUL UZOMA (MHR)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:UZOMA
Last Name:NWAIWU
Suffix:
Gender:M
Credentials:MHR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8440 NW 85TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-3239
Mailing Address - Country:US
Mailing Address - Phone:405-706-7036
Mailing Address - Fax:
Practice Address - Street 1:10400 VINEYARD BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-3829
Practice Address - Country:US
Practice Address - Phone:405-848-5620
Practice Address - Fax:405-848-5619
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health