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General NPI Number Information
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NPI Number | 1144715970
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Entity Type | Individual
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Provider Name | UCHE EZIAKU NWAOGAZIE MD
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Gender | Female
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Dates
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Enumeration Date | 06/25/2018
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 1100 CENTRAL AVE SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4930
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Country | US
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Telephone | 505-563-6530
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Fax | 505-563-6378
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Provider Business Mailing Address
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Address Line | 800 BRADBURY DR SE STE 116
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4310
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Country | US
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Telephone | 505-272-1476
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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 | 2080P0210X
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Taxonomy Name | Pediatric Nephrology Physician
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License Number | MT222789
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 125.072363
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2080P0210X
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Taxonomy Name | Pediatric Nephrology Physician
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License Number | MD2024-0527
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License Number State | NM
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