Provider Demographics
NPI:1891828448
Name:UCHE, CHIDI CHRIS UKO (MD)
Entity Type:Individual
Prefix:
First Name:CHIDI
Middle Name:CHRIS UKO
Last Name:UCHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 UNIVERSITY BLVD N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-8850
Mailing Address - Country:US
Mailing Address - Phone:832-651-0323
Mailing Address - Fax:
Practice Address - Street 1:1126 UNIVERSITY BLVD N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-8850
Practice Address - Country:US
Practice Address - Phone:832-651-0323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97989207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000352000Medicaid