Provider Demographics
NPI:1639461395
Name:UGWU, DANA CHANELLE (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:CHANELLE
Last Name:UGWU
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:DANA
Other - Middle Name:CHANELLE
Other - Last Name:ROLLERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:5300 N INDEPENDENCE AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5555
Mailing Address - Country:US
Mailing Address - Phone:405-844-4300
Mailing Address - Fax:405-844-4366
Practice Address - Street 1:1700 RENAISSANCE BLVD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3022
Practice Address - Country:US
Practice Address - Phone:405-844-4300
Practice Address - Fax:405-844-4366
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK35536207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine