Basic Information
| Provider Information | |||||||||
| NPI: | 1063731594 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EMARIEVBE | ||||||||
| FirstName: | ADA | ||||||||
| MiddleName: | UKPAI | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9308 CANTERBURY RIDING | ||||||||
| Address2: | |||||||||
| City: | LAUREL | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207231426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9738091372 | ||||||||
| FaxNumber: | 2407865646 | ||||||||
| Practice Location | |||||||||
| Address1: | 5100 AUTH WAY | ||||||||
| Address2: | |||||||||
| City: | SUITLAND | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207464207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017025000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2010 | ||||||||
| LastUpdateDate: | 06/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207V00000X | MTL001065 | DC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.