Healthcare Provider Details
I. General information
NPI: 1225426257
Provider Name (Legal Business Name): UZOMA CHIDINMA OBIAKA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/29/2014
Last Update Date: 08/11/2021
Certification Date: 08/11/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1601 CENTER ST
MOBILE AL
36604-1541
US
IV. Provider business mailing address
PO BOX 746450
ATLANTA GA
30374-6450
US
V. Phone/Fax
- Phone: 251-410-5437
- Fax: 251-434-3783
- Phone: 251-434-3626
- Fax: 251-445-2464
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0202X |
| Taxonomy | Pediatric Cardiology Physician |
| License Number | 42282 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: