Provider Demographics
NPI:1619710480
Name:OZOEMELAM, UCHECHUKWU FELIX
Entity type:Individual
Prefix:MR
First Name:UCHECHUKWU
Middle Name:FELIX
Last Name:OZOEMELAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11416 E FLEETING SUNSET TRL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85747-6209
Mailing Address - Country:US
Mailing Address - Phone:302-670-6915
Mailing Address - Fax:
Practice Address - Street 1:11416 E FLEETING SUNSET TRL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-6209
Practice Address - Country:US
Practice Address - Phone:302-670-6915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD10663432172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver