Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | MT222789 | PA |
NPI | 1144715970 |
---|---|
Provider Name | Dr. Uche Eziaku Nwaogazie |
First Address | Chicago, IL 60411 |
Second Address | Philadelphia, PA 19104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2018 |
Last Update Date | 22/06/2021 |