Provider Demographics
NPI:1679748107
Name:NWAUBANI, ARTHUR EBERE (MD)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:EBERE
Last Name:NWAUBANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 490950
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34749-0950
Mailing Address - Country:US
Mailing Address - Phone:352-431-3600
Mailing Address - Fax:352-460-0853
Practice Address - Street 1:312 S LAKE ST
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-5920
Practice Address - Country:US
Practice Address - Phone:352-431-3600
Practice Address - Fax:352-460-0853
Is Sole Proprietor?:No
Enumeration Date:2008-04-25
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1068752084N0402X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology