MEDICARE: NGOZI J WAMUO 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	2084P0800X	Psychiatry Physician	42107	MN

General Provider Information

NPI Number	:	1447282231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NGOZI J WAMUO MD

Provider Business Mailing Address
First Line	:	2215 E LAKE ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-4385
Country	:	US
Telephone Number	:	612-596-9438
Fax Number	:	612-329-4500

Provider Business Practice Location Address
First Line	:	2215 E LAKE ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-4385
Country	:	US
Telephone Number	:	612-596-9438
Fax Number	:	612-329-4500

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	01/28/2026

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