Healthcare Provider Details

I. General information

NPI: 1033215371
Provider Name (Legal Business Name): UCHECHI T OPAIGBEOGU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6188 OXON HILL ROAD SUITE 701
OXON HILL MD
20745
US

IV. Provider business mailing address

6188 OXON HILL RD SUITE 701
OXON HILL MD
20745-3113
US

V. Phone/Fax

Practice location:
  • Phone: 301-686-0067
  • Fax: 301-686-0479
Mailing address:
  • Phone: 301-686-0067
  • Fax: 301-686-0411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0037066
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: