Chidalu N. Ibeneme, ASSISTANT PHYSICIAN

NPI #1891680542 in Grandview, Missouri

Provider Information

NPI Number: 1891680542
Entity Type: Individual
Name: Chidalu N. Ibeneme, ASSISTANT PHYSICIAN
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: ASSISTANT PHYSICIAN
Enumeration Date: Jun 12, 2025
Last Updated: Jun 12, 2025

Practice Location

Address: 13013 FULLER AVE STE A
City: Grandview
State: Missouri
ZIP Code: 64030-2687
Phone: (419) 204-9575

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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