Provider Demographics
NPI:1740819804
Name:OGWU, OGHANIM IFEOMA (MD)
Entity type:Individual
Prefix:DR
First Name:OGHANIM
Middle Name:IFEOMA
Last Name:OGWU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3939 7TH STREET RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-4103
Mailing Address - Country:US
Mailing Address - Phone:502-883-6800
Mailing Address - Fax:502-384-2316
Practice Address - Street 1:3939 7TH STREET RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-4103
Practice Address - Country:US
Practice Address - Phone:502-883-6800
Practice Address - Fax:502-384-2316
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP722207R00000X
KY58442207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine