Healthcare Provider Details

I. General information

NPI: 1558479642
Provider Name (Legal Business Name): UZOMA VIVIAN NRIAGU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 06/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 I ST SE APT 606
WASHINGTON DC
20003-4861
US

IV. Provider business mailing address

100 I ST SE APT 606
WASHINGTON DC
20003-4861
US

V. Phone/Fax

Practice location:
  • Phone: 734-717-1229
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberM7479
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD74857
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: