MEDICARE: DR. SIDDON UGOCHUKWU NWAKPUDA M.D

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1699906602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIDDON UGOCHUKWU NWAKPUDA M.D

Provider Business Mailing Address
First Line	:	2075 MORRIS AVE APT 145
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-6071
Country	:	US
Telephone Number	:	201-640-9799
Fax Number	:

Provider Business Practice Location Address
First Line	:	2075 MORRIS AVE APT 145
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-6071
Country	:	US
Telephone Number	:	201-640-9799
Fax Number	:

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

Provider Enumeration Date	:	08/07/2009
Last Update Date	:	08/07/2009

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