Individual
CELESTINE CHIMA EMMANUEL ISHIEKWENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. MBA
Contact information
Practice address
700 E MARSHALL AVE, LONGVIEW, TX 75601-5580
(903) 315-1488
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
MD-43908
IA
207RI0200X
Infectious Disease Physician
Primary
S2995
TX
208M00000X
Hospitalist Physician
S2995
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
408583901
—
TX
01
—
8LZ497
BCBS
TX
01
—
933562
MEDICARE
TX
Enumeration date
07/17/2012
Last updated
09/27/2023
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