Provider Demographics
NPI:1992901409
Name:OBUEKWE, UZOMA N (MD)
Entity type:Individual
Prefix:
First Name:UZOMA
Middle Name:N
Last Name:OBUEKWE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:UZOMA
Other - Middle Name:N
Other - Last Name:NWANKWOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2001 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24201-3609
Mailing Address - Country:US
Mailing Address - Phone:276-644-4433
Mailing Address - Fax:276-644-4434
Practice Address - Street 1:2001 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24201-3609
Practice Address - Country:US
Practice Address - Phone:276-644-4433
Practice Address - Fax:276-644-4434
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46386207Q00000X
VA0101244053207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA022783S10Medicare PIN
TN103I086897Medicare PIN
VAVV5574B288Medicare PIN