Provider Demographics
NPI:1932493046
Name:EBELE, CHIDINMA
Entity Type:Individual
Prefix:
First Name:CHIDINMA
Middle Name:
Last Name:EBELE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23447 TAILOR SHOP PL
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-4359
Mailing Address - Country:US
Mailing Address - Phone:240-688-5964
Mailing Address - Fax:
Practice Address - Street 1:23447 TAILOR SHOP PL
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:MD
Practice Address - Zip Code:20871
Practice Address - Country:US
Practice Address - Phone:240-688-5964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management