Provider Demographics
NPI:1235814849
Name:CHIBUEZE, STANLEY SOMTOOCHUKWU (MD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:SOMTOOCHUKWU
Last Name:CHIBUEZE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:STANLEY
Other - Middle Name:
Other - Last Name:CHIBUEZE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:CAMPUS BOX 8134
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1093
Mailing Address - Country:US
Mailing Address - Phone:314-362-2462
Mailing Address - Fax:314-362-0193
Practice Address - Street 1:1 BARNES JEW HOSP PLZ
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-362-2462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20230238472084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry