Provider Demographics
NPI:1528276052
Name:UCHE, CHUKWUDUM (MD)
Entity type:Individual
Prefix:
First Name:CHUKWUDUM
Middle Name:
Last Name:UCHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1450 W HORIZON RIDGE PKWY
Mailing Address - Street 2:B304 #668
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-4477
Mailing Address - Country:US
Mailing Address - Phone:702-868-8387
Mailing Address - Fax:702-314-9134
Practice Address - Street 1:6088 S DURANGO DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-1780
Practice Address - Country:US
Practice Address - Phone:702-380-4242
Practice Address - Fax:702-380-4141
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV12360207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1528276052Medicaid
NV1528276052Medicaid