NPIMap

Individual provider Active NPI

Uduak Akan-Etuk, M.D.

  • Internal Medicine Physician
  • Midlothian, VA
National Provider Identifier
1992798714
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101049496 Issued in VA
Practice address
2904 Leatherwood Way
Midlothian, VA 23113-1413
Phone
(804) 378-6003
Fax
(804) 378-6003
NPI assigned
Aug 26, 2005
Last updated
Sep 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101049496 VA
Internal Medicine Physician 207R00000X 0101049496 VA Primary

Addresses

Primary practice location

2904 Leatherwood Way
Midlothian, VA 23113-1413

Mailing address

2904 Leatherwood Way
Midlothian, VA 23113-1413

Other identifiers 2

IdentifierTypeStateIssuer
010396450MedicaidVA
010396476MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040617001769 VA Practitioner - Emergency MedicinePractitioner - Internal Medicine 6204810963 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101049496VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Jan 1, 2019 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Monacan Emgergency Physicians Emergency Medicine Past Accepting new patients
Virginia Em-I Medical Services, PC Emergency Medicine Past Accepting new patients
Virginia Em-I Medical Services, PC Emergency Medicine Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Sterling Emergency Services of Virginia Inc Emergency Medicine Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Richmond Community Emergency Assoc Emergency Medicine Past Accepting new patients
Ecs of Virginia, Inc. Emergency Medicine Past Accepting new patients
Emergency Medicine of Indiana Emergency Medicine Past Accepting new patients

Locations

411 W Randolph Rd
Hopewell, VA 23860
Phone (804) 452-3624

1700 Temple Pkwy
Prince George, VA 23875
Phone (804) 541-1600

1602 Skipwith Rd
Richmond, VA 23229
Phone (804) 289-4500

2621 Grove Ave
Richmond, VA 23220
Phone (804) 252-5433

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

Organizations & group practices 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1992798714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2904 LEATHERWOOD WAY",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231131413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2904 LEATHERWOOD WAY",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231131413",
            "telephone_number": "804-378-6003",
            "fax_number": "804-378-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKAN-ETUK",
        "first_name": "UDUAK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101049496",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101049496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010396450",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010396476",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.