# WINDHAM PRIMARY CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780874776
- **Authorized official:** DR. OBINNA I MADUKA MD (OWNER)
- **Authorized official phone:** (860) 456-1279

## Contact information

- **Practice address:** 387 TUCKIE RD STE C, NORTH WINDHAM, CT 06256-1355
- **Practice address phone:** (860) 456-1279
- **Practice address fax:** (860) 456-1298
- **Mailing address:** 387 TUCKIE RD STE C, NORTH WINDHAM, CT 06256-1355
- **Mailing address phone:** (860) 456-1279
- **Mailing address fax:** (860) 456-1298

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 037518 | CT | Yes |

## Other

- **Enumeration date:** 07/26/2007
- **Last updated:** 07/26/2007