Provider Demographics
NPI:1447939517
Name:UZOUKWU, MARY
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:UZOUKWU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3404 SPECTACULAR BID CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1284
Mailing Address - Country:US
Mailing Address - Phone:240-494-6078
Mailing Address - Fax:
Practice Address - Street 1:3404 SPECTACULAR BID CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-1284
Practice Address - Country:US
Practice Address - Phone:240-494-6078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-14
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No171W00000XOther Service ProvidersContractor