Healthcare Provider Details

I. General information

NPI: 1689137713
Provider Name (Legal Business Name): NGOZI UCHENNA UWAKWE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2019
Last Update Date: 04/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5403A ANNAPOLIS RD
BLADENSBURG MD
20710-2201
US

IV. Provider business mailing address

3323 SIR THOMAS DR APT 43
SILVER SPRING MD
20904-4835
US

V. Phone/Fax

Practice location:
  • Phone: 301-277-7107
  • Fax:
Mailing address:
  • Phone: 240-237-0976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26140
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: