Provider Demographics
NPI:1356351928
Name:IHEME, UCHE G (MD)
Entity type:Individual
Prefix:DR
First Name:UCHE
Middle Name:G
Last Name:IHEME
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:PO BOX 74113
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44194-4113
Mailing Address - Country:US
Mailing Address - Phone:216-383-6776
Mailing Address - Fax:440-232-3147
Practice Address - Street 1:88 CENTER RD
Practice Address - Street 2:SUITE 130
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-2700
Practice Address - Country:US
Practice Address - Phone:216-383-0100
Practice Address - Fax:440-232-3147
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35075383207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2155608Medicaid
H04390Medicare UPIN
OH2155608Medicaid