Organization
MALOZERA PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXANDER C IBEZI-ENENDU DO (OWNER)
(404) 702-9466
Entity
Organization
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) 783-3610
(478) 783-3611
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/29/2019
Last updated
11/18/2023
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