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General NPI Number Information
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NPI Number | 1043622343
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Entity Type | Individual
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Provider Name | OMICI UWAGBAI M.D., M.P.H.
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Gender | Female
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Dates
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Enumeration Date | 05/21/2014
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 906 BINGHAM DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-2842
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Country | US
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Telephone | 910-213-3547
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 746724
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City | ATLANTA
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State | GA
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Zip | 30374-6724
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Country | US
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Telephone | 312-733-9730
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2019-00622
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 2019-00622
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License Number State | NC
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