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General NPI Number Information
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NPI Number | 1780940973
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Entity Type | Organization
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Legal Business Name | MCRICHLANDS PLLC
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Dates
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Enumeration Date | 04/02/2012
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Last Update Date | 10/03/2021
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Provider Practice Location Address
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Address Line | 9580 N US HIGHWAY 301
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City | WILDWOOD
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State | FL
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Zip | 34785-1762
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Country | US
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Telephone | 352-633-0703
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Fax | 352-399-2168
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Provider Business Mailing Address
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Address Line | 9580 N US HIGHWAY 301
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City | WILDWOOD
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State | FL
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Zip | 34785
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Country | US
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Telephone | 352-633-0703
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Fax | 352-399-2168
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | UZOMA KELECHI NWAUBANI
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Credential | MD
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Telephone | 352-633-0703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | ME105721
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License Number State | FL
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