Individual provider Active NPI

Alexander Egwuatu J Ukoh, MD

  • Surgery Physician
  • Riverdale, MD
National Provider Identifier
1396735262
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D0048077 Issued in MD
Practice address
4404 Queensbury Rd
Riverdale, MD 20737-1068
Phone
(301) 927-1800
Fax
(301) 927-4020
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X D0048077 MD Primary

Addresses

Primary practice location

4404 Queensbury Rd
Riverdale, MD 20737-1068

Mailing address

4404 Queensbury Rd
Riverdale, MD 20737-1068
Phone (301) 927-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0048077MDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hemorrhoid Relief Center of Virginia, Inc. Past Accepting new patients
Atlantic General Hospital Corporation Surgery Past Accepting new patients
Atlantic Immedicare LLC Past Accepting new patients
Genesis Eldercare Physician Services LLC PastSince Mar 24, 2012 Accepting new patients
Genesis Eldercare Physician Services LLC Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1396735262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4404 QUEENSBURY RD",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371068",
            "telephone_number": "301-927-1800",
            "fax_number": "301-927-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4404 QUEENSBURY RD",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371068",
            "telephone_number": "301-927-1800",
            "fax_number": "301-927-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UKOH",
        "first_name": "ALEXANDER",
        "middle_name": "EGWUATU J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D0048077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.