Provider Demographics
NPI:1912918319
Name:UBOGU, EROBOGHENE EKAMERENO (MD)
Entity Type:Individual
Prefix:DR
First Name:EROBOGHENE
Middle Name:EKAMERENO
Last Name:UBOGU
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 1:1720 7TH AVE S
Mailing Address - Street 2:SPARKS CENTER SUITE 200
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-0017
Mailing Address - Country:US
Mailing Address - Phone:205-934-2120
Mailing Address - Fax:
Practice Address - Street 1:1720 7TH AVE S
Practice Address - Street 2:SUITE 200
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0017
Practice Address - Country:US
Practice Address - Phone:205-934-2120
Practice Address - Fax:205-975-6758
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL327892084N0008X, 2084N0600X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196170801Medicaid
TX196170802Medicaid
TX8K8936Medicare PIN
TX8L1364Medicare PIN
TXTXB113815Medicare PIN
TXP00954287Medicare PIN