Provider Demographics
NPI:1932386075
Name:NWABUZOR, RICHARD GIFT
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:GIFT
Last Name:NWABUZOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8027 W CARMEN AVE
Mailing Address - Street 2:TRUMED TRANSPORT SERVICE
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-2118
Mailing Address - Country:US
Mailing Address - Phone:414-466-7898
Mailing Address - Fax:
Practice Address - Street 1:8027 W CARMEN AVE
Practice Address - Street 2:TRUMED TRANSPORT SERVICE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-2118
Practice Address - Country:US
Practice Address - Phone:414-466-7898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI41447000343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41447000Medicaid