Provider Demographics
NPI:1306918123
Name:UGOCHUKWU, KINGSLEY CHUKS (MD)
Entity type:Individual
Prefix:DR
First Name:KINGSLEY
Middle Name:CHUKS
Last Name:UGOCHUKWU
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 517
Mailing Address - Street 2:ANGIER PEDIATRICS AND ADULT MEDICAL CENTER, PLLC
Mailing Address - City:FUQUAY-VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-0512
Mailing Address - Country:US
Mailing Address - Phone:919-577-0481
Mailing Address - Fax:919-577-0512
Practice Address - Street 1:441 LAKESTONE COMMONS AVENUE
Practice Address - Street 2:ANGIER PEDIATRICS AND ADULT MEDICAL CENTER, PLLC
Practice Address - City:FUQUAY-VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-6972
Practice Address - Country:US
Practice Address - Phone:919-577-0481
Practice Address - Fax:919-577-0512
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2014-02-05
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Provider Licenses
StateLicense IDTaxonomies
NC200400088207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2384996OtherUNITED HEALTH CARE
NC218912OtherWELL PATH
NC2932032OtherCIGNA
NC136U6OtherBLUE CROSS BLUE SHIELD
NC8913646Medicaid
NCP00255190OtherRAILROAD MEDICARE
NC2932032OtherCIGNA
NC8913646Medicaid