MEDICARE: ROSE ONYINYECHI URADU MD

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
1	207Q00000X	Family Medicine Physician	40541	KY
2	207QA0401X	Addiction Medicine (Family Medicine) Physician	40541	KY

General Provider Information

NPI Number	:	1326050634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSE ONYINYECHI URADU MD

Provider Business Mailing Address
First Line	:	401 CAMDEN RD
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25704-2708
Country	:	US
Telephone Number	:	606-393-4632
Fax Number	:	888-411-4131

Provider Business Practice Location Address
First Line	:	3655 WINCHESTER AVE
Second Line	:
City	:	ASHLAND
State	:	KY
Zip	:	41101-7739
Country	:	US
Telephone Number	:	606-393-4632
Fax Number	:	888-411-4131

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	05/05/2021

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