Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 487 | NC |
N | 213ES0131X | Foot Surgery | 487 | NC |
NPI | 1275630295 |
---|---|
Provider Name | Dr. Chukwuma Ukata |
First Address | Garner, NC 27529-3600 |
Second Address | Garner, NC 27529-3600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 27/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
89046HI | (05) | NC |
V00143 | (02) | NC |