1194089870 NPI number — NGOZI UCHENNA OBI M.D

Table of content: NGOZI UCHENNA OBI M.D (NPI 1194089870)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194089870 NPI number — NGOZI UCHENNA OBI M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OBI
Provider First Name:
NGOZI
Provider Middle Name:
UCHENNA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194089870
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
NORTH HILLS HEALTH CENTER
Provider Second Line Business Mailing Address:
W129 N7055 NORTHFIELD DRIVE
Provider Business Mailing Address City Name:
MENOMONEE FALLS
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53051
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
262-253-5150
Provider Business Mailing Address Fax Number:
262-253-6058

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3001 HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHEVERLY
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20785-1189
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-618-3776
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2083X0100X , with the licence number: 21091-875 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 21091-875 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




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