Individual
MARTIN IBEAWUCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13 BLACK HORSE PIKE APT 2B, HADDON HEIGHTS, NJ 08035-1042
(863) 835-0107
Mailing address
13 BLACK HORSE PIKE APT 2B, HADDON HEIGHTS, NJ 08035-1042
(863) 835-0107
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
844821
TX
Other
Enumeration date
10/17/2013
Last updated
10/17/2013
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