Provider Demographics
NPI:1679924013
Name:UMUKORO, PETER ELOHO (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:ELOHO
Last Name:UMUKORO
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 1:112 HOSPITAL LN STE 302
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46122-1998
Mailing Address - Country:US
Mailing Address - Phone:317-718-2460
Mailing Address - Fax:317-718-2465
Practice Address - Street 1:100 HOSPITAL LN STE 145
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-2000
Practice Address - Country:US
Practice Address - Phone:317-718-2460
Practice Address - Fax:317-718-2465
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01082216A207RN0300X
WI6108851390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program