Individual
DOMINGO ERNESTO UCEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 316-5151
Mailing address
585 ROSE BORDER DR, ROSWELL, GA 30075-7156
(678) 502-6690
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
GA
Other
Enumeration date
04/19/2021
Last updated
04/19/2021
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