Healthcare Provider Details

I. General information

NPI: 1962082958
Provider Name (Legal Business Name): UCHE GINAH NWAGU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 CAMBRIDGE ST
KANSAS CITY KS
66160-8501
US

IV. Provider business mailing address

908 LONGFELLOW AVE
ROYAL OAK MI
48067-4527
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-1227
  • Fax:
Mailing address:
  • Phone: 248-818-4887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number2026014797
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number2026014797
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number04-53293
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number04-53293
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: