Provider Demographics
NPI:1285606269
Name:UKAONU, CHINWE (MD)
Entity type:Individual
Prefix:
First Name:CHINWE
Middle Name:
Last Name:UKAONU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2548
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31702-2548
Mailing Address - Country:US
Mailing Address - Phone:229-312-5800
Mailing Address - Fax:229-312-5853
Practice Address - Street 1:2336 DAWSON RD
Practice Address - Street 2:STE 1500
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-2442
Practice Address - Country:US
Practice Address - Phone:229-312-8800
Practice Address - Fax:229-312-8895
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053963207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA08BBRGDMedicare ID - Type Unspecified
GAI15883Medicare UPIN