Provider Demographics
NPI:1750359964
Name:UZOUKWU, UCHENNA (MD)
Entity type:Individual
Prefix:
First Name:UCHENNA
Middle Name:
Last Name:UZOUKWU
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 1:881 3RD ST STE B5
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-5929
Mailing Address - Country:US
Mailing Address - Phone:610-776-9440
Mailing Address - Fax:610-776-9444
Practice Address - Street 1:881 3RD ST STE B5
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-5929
Practice Address - Country:US
Practice Address - Phone:610-776-9440
Practice Address - Fax:610-776-9444
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD059079L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015954270009Medicaid
PA0015954270009Medicaid
PA180890UWPMedicare PIN