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Individual

NDUKWE KALU UDUMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4101 UNIVERSITY BLVD, TYLER, TX 75701-6623
(903) 594-2450
Mailing address
11937 US HIGHWAY 271, TYLER, TX 75708-3154
(903) 877-7168
(903) 877-8355

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
238106
NY
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
M5955
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8S5939
BCBS
TX
01
P00692926
RAILROAD MEDICARE
TX
Enumeration date
10/03/2006
Last updated
09/14/2021
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