Provider Demographics
NPI:1770752891
Name:UGOKWE, KENE TERENCE (MD)
Entity type:Individual
Prefix:DR
First Name:KENE
Middle Name:TERENCE
Last Name:UGOKWE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:540 PARMALEE AVE
Mailing Address - Street 2:STE 510
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44510-1716
Mailing Address - Country:US
Mailing Address - Phone:330-743-1928
Mailing Address - Fax:330-744-2110
Practice Address - Street 1:540 PARMALEE AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44510-1716
Practice Address - Country:US
Practice Address - Phone:330-743-1928
Practice Address - Fax:330-744-2110
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI52597207T00000X
OH35.091867207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH073551OtherMEDICARE PTAN
OH3049089Medicaid