Provider Demographics
NPI:1568511269
Name:UGORJI, CHIKA (MD)
Entity type:Individual
Prefix:
First Name:CHIKA
Middle Name:
Last Name:UGORJI
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 1:29674 N 114TH DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-4565
Mailing Address - Country:US
Mailing Address - Phone:904-994-4532
Mailing Address - Fax:
Practice Address - Street 1:127 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-5646
Practice Address - Country:US
Practice Address - Phone:928-951-0395
Practice Address - Fax:928-492-9319
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN9057208000000X
FLME101681208000000X
CAA112694208000000X
NY260587208000000X
AZ56371208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0001046-00Medicaid
FL0001046-00Medicaid