MEDICARE: UGOCHUKWU NWOKORO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35078825N	OH
2	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician	35078825-N	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013919778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UGOCHUKWU NWOKORO MD

Provider Business Mailing Address
First Line	:	1735 BIG HILL RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45439-2201
Country	:	US
Telephone Number	:	937-224-4325
Fax Number	:	937-224-4327

Provider Business Practice Location Address
First Line	:	1735 BIG HILL RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45439-2201
Country	:	US
Telephone Number	:	937-224-4325
Fax Number	:	937-224-4327

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	05/01/2023

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