Individual
DOMINIC U CHIBUEZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
805 WEST KANSAS AVENUE, JAL, NM 88252-2525
(505) 395-3400
(505) 395-2781
Mailing address
PO BOX Z, 805 W KANSAS ST, JAL, NM 88252-2525
(505) 395-3400
(505) 395-2781
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
NM97207
NM
Other
Enumeration date
12/08/2006
Last updated
07/08/2007
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