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General NPI Number Information
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NPI Number | 1790087732
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Entity Type | Individual
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Provider Name | PROMISE OJUKWU M.D
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Gender | Male
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Dates
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Enumeration Date | 11/24/2010
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Last Update Date | 11/02/2022
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Provider Practice Location Address
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Address Line | 5320 S RAINBOW BLVD STE 182
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City | LAS VEGAS
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State | NV
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Zip | 89118-1896
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Country | US
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Telephone | 702-255-3547
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Fax | 702-212-4993
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Provider Business Mailing Address
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Address Line | 6355 S BUFFALO DR FL 3
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City | LAS VEGAS
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State | NV
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Zip | 89113-2133
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Country | US
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Telephone | 702-216-3346
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Fax | 702-671-6883
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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 | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 036136819
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 17523
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License Number State | NV
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