MEDICARE: MR. EUGENE OGBONNA ONWUZURIKE ARRT R CT

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	247100000X	Radiologic Technologist	323983

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10581	OTHER	NC	NCSRT
2	323983	OTHER		ARRT

General Provider Information

NPI Number	:	1346454659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EUGENE OGBONNA ONWUZURIKE ARRT R CT

Provider Business Mailing Address
First Line	:	1513 BEACON VALLEY DRIVE
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27604
Country	:	US
Telephone Number	:	919-212-2398
Fax Number	:	919-212-2798

Provider Business Practice Location Address
First Line	:	1513 BEACON VALLEY DRIVE
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27604
Country	:	US
Telephone Number	:	919-212-2398
Fax Number	:	919-212-2798

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

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	07/08/2007

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