Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 2017-01659 | NC |
N | 207QA0505X | Family Doctor - Adult Medicine | 216979 | NC |
NPI | 1215342779 |
---|---|
Provider Name | Dr. Alexandria Marie Ukleja |
First Address | Greensboro, NC 27405-5655 |
Second Address | Greensboro, NC 27405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2014 |
Last Update Date | 25/01/2022 |