MEDICARE: UGOCHUKWU NWUDE 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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	E-10626	AR

General Provider Information

NPI Number	:	1477817914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UGOCHUKWU NWUDE MD

Provider Business Mailing Address
First Line	:	100 E CHURCH ST
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-4602
Country	:	US
Telephone Number	:	870-862-2331
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 E CHURCH ST
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-4602
Country	:	US
Telephone Number	:	870-862-2331
Fax Number	:

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

Provider Enumeration Date	:	06/29/2012
Last Update Date	:	01/17/2025

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Directions to “ UGOCHUKWU NWUDE MD” Practice Location

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