Individual
MR. DMITRI KIBENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-2000
Mailing address
7431 FOWLER SPRINGS LN, CHARLOTTE, NC 28212-6989
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
260206
NC
Other
Enumeration date
11/29/2018
Last updated
01/04/2019
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