Basic Information
| Provider Information | |||||||||
| NPI: | 1760621981 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UZOMA BEN GBULIE MD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4 JOYCETON TER | ||||||||
| Address2: | |||||||||
| City: | UPPER MARLBORO | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207741334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2403939677 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2041 GEORGIA AVE NW | ||||||||
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| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200600001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028656100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2009 | ||||||||
| LastUpdateDate: | 02/11/2009 | ||||||||
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| AuthorizedOfficialLastName: | GBULIE | ||||||||
| AuthorizedOfficialFirstName: | UZOMA | ||||||||
| AuthorizedOfficialMiddleName: | BEN | ||||||||
| AuthorizedOfficialTitleorPosition: | GENERAL SURGEON | ||||||||
| AuthorizedOfficialTelephone: | 2403939677 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | MD035694 | DC | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.