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Individual
CESAR B IBANEZ II
Active
Individual
CESAR B IBANEZ II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10816
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001719573
BLUE CROSS BLUE SHIELD
WV
05
—
0048653000
—
WV
05
—
0355208
—
OH
01
—
3001332
WORKERS COMPENSATION
WV
05
—
64941982
—
KY
Enumeration date
05/17/2006
Last updated
08/03/2016
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