Individual
CONSTANTINE CHIDIEBUBE CHIMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1551 S SECOND ST, GALLUP, NM 87301-5881
(505) 863-7993
Mailing address
1551 S SECOND ST, GALLUP, NM 87301-5881
(505) 863-7993
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2023-1278
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/27/2019
Last updated
08/24/2024
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