Healthcare Provider Details

I. General information

NPI: 1346552692
Provider Name (Legal Business Name): OBIAGELI UCHENNA OGBATA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OBIAGELI UCHENNA OJUKWU M.D.

II. Dates (important events)

Enumeration Date: 07/01/2010
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 QUEENS RD STE 400
CHARLOTTE NC
28204-3215
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 980-302-6400
  • Fax: 980-302-6405
Mailing address:
  • Phone: 704-316-4485
  • Fax: 704-316-4490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number2010-01465
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number2010-01465
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number201001465
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number201001465
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: