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NPI Code Detail

MEDICARE: DR. OKECHUKWU ERNEST OBUA M.D

MEDICARE: DR. OKECHUKWU ERNEST OBUA M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QA0401XAddiction Medicine (Family Medicine) PhysicianP0920TX
2207QA0401XAddiction Medicine (Family Medicine) PhysicianC1-0011566DE
3261Q00000XClinic/CenterMD438370PA
4207Q00000XFamily Medicine PhysicianC1-0011566DE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053521583
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. OKECHUKWU ERNEST OBUA M.D
Provider Business Mailing Address
First Line : 13902 LITTLE CT
Second Line :
City : HOUSTON
State : TX
Zip : 77077-1958
Country : US
Telephone Number : 214-621-4604
Fax Number :
Provider Business Practice Location Address
First Line : 590 NAAMANS RD
Second Line :
City : CLAYMONT
State : DE
Zip : 19703-2308
Country : US
Telephone Number : 833-886-2277
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 02/08/2023

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