Provider Demographics
NPI:1649335092
Name:ONUOHA, PATIENCE C (DO)
Entity type:Individual
Prefix:DR
First Name:PATIENCE
Middle Name:C
Last Name:ONUOHA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 N. MERIDIAN
Mailing Address - Street 2:PROVIDER ENROLLMENT SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-3908
Mailing Address - Country:US
Mailing Address - Phone:317-962-4944
Mailing Address - Fax:317-962-4950
Practice Address - Street 1:1800 N. CAPITOL AVENUE
Practice Address - Street 2:SUITE E-140
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1218
Practice Address - Country:US
Practice Address - Phone:317-962-2894
Practice Address - Fax:317-962-5285
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004021478207R00000X
WV3246208M00000X
IN02003342A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208779603Medicaid
MO925153230Medicare PIN
MOI18336Medicare UPIN
MO208779603Medicaid
INM400045155Medicare PIN