Individual
ALEXANDER CHUKWUMA IBEZI-ENENDU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2809 PINE ST, UNADILLA, GA 31091-7701
(478) 355-3000
(478) 355-3001
Mailing address
P O BOX 8203, WARNER ROBINS, GA 31095-8203
(478) 355-3000
(478) 355-3001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
5101019441
MI
207Q00000X
Family Medicine Physician
Primary
75636
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003167544B
—
GA
Enumeration date
06/09/2011
Last updated
11/18/2023
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