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Individual
DR. DANIELLE IBELEMA
Active
Individual
DR. DANIELLE IBELEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
76263
GA
2080A0000X
Pediatric Adolescent Medicine Physician
076263
GA
2084P0800X
Psychiatry Physician
76263
GA
2084P0804X
Child & Adolescent Psychiatry Physician
76263
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076263
MEDICAL LICENSE
GA
Enumeration date
05/27/2011
Last updated
01/13/2021
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