Provider Demographics
NPI:1912028853
Name:NWOBI, OBINNA UCHENNA (MD)
Entity Type:Individual
Prefix:DR
First Name:OBINNA
Middle Name:UCHENNA
Last Name:NWOBI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1121 1ST ST S
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-3902
Mailing Address - Country:US
Mailing Address - Phone:877-817-8346
Mailing Address - Fax:321-286-0517
Practice Address - Street 1:1121 1ST ST S
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-3902
Practice Address - Country:US
Practice Address - Phone:877-817-8346
Practice Address - Fax:321-286-0517
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08134900208600000X
FLME1066332086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0471260001Medicare NSC