Provider Demographics
NPI:1023469541
Name:UCHE-ABBA, EMMANUEL
Entity type:Individual
Prefix:MR
First Name:EMMANUEL
Middle Name:
Last Name:UCHE-ABBA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 NW 75TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-3972
Mailing Address - Country:US
Mailing Address - Phone:405-501-4160
Mailing Address - Fax:
Practice Address - Street 1:3824 N MERIDIAN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-2853
Practice Address - Country:US
Practice Address - Phone:405-501-4160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator