Healthcare Provider Details

I. General information

NPI: 1376871210
Provider Name (Legal Business Name): MOSES CHUKWUEMEKA UYADI SR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2009
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2609 ATLANTIC AVE STE 101A
RALEIGH NC
27604-1550
US

IV. Provider business mailing address

3552 BONITA GROVE DR
RALEIGH NC
27604-9713
US

V. Phone/Fax

Practice location:
  • Phone: 919-649-2586
  • Fax: 919-424-7361
Mailing address:
  • Phone: 919-649-2586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: