Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 40541 | KY |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 40541 | KY |
NPI | 1326050634 |
---|---|
Provider Name | Rose Onyinyechi Uradu |
First Address | Huntington, WV 25704-2708 |
Second Address | Ashland, KY 41101-7739 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 05/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I63400 | (02) |