Healthcare Provider Details

I. General information

NPI: 1073170429
Provider Name (Legal Business Name): UZOAGU ALEXIS OKONKWO MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2019
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

459 PATTERSON RD
HONOLULU HI
96819-1522
US

IV. Provider business mailing address

459 PATTERSON RD
HONOLULU HI
96819-1522
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-0600
  • Fax:
Mailing address:
  • Phone: 808-433-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD-22680-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: