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Individual

DR. GODWIN OBINNA UZOMBA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4456 CENTRAL AVE, CHARLOTTE, NC 28205-5702
(980) 299-0023
Mailing address
4456 CENTRAL AVE, CHARLOTTE, NC 28205-5702
(980) 299-0023

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
200000152
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
014KK
BCBS NC-GROUP #
NC
01
1277F
BCBS NC-INDIVIDUAL #
NC
01
582305218
BCBS SC - PINEVILLE
NC
01
582305218001
BCBS SC-ROCK HILL
SC
01
582305218002
BCBS SC - LANCASTER
SC
05
891277F
NC
01
AETNA
7715252-PPO
05
GP3653
SC
01
MAMSI
2104818
01
MEDCOST
C6405
01
TRICARE
582305218-GROUP #
01
UNITED HEALTHCARE
2279397-INDIVIDUAL
Enumeration date
06/14/2005
Last updated
08/04/2019
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