Provider Demographics
NPI:1649451683
Name:MALTBIA, CHYKEETRA S (MD)
Entity type:Individual
Prefix:DR
First Name:CHYKEETRA
Middle Name:S
Last Name:MALTBIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5011 GOVERNMENT BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-5029
Mailing Address - Country:US
Mailing Address - Phone:251-447-2953
Mailing Address - Fax:251-447-2745
Practice Address - Street 1:5011 GOVERNMENT BLVD STE B
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-5029
Practice Address - Country:US
Practice Address - Phone:251-447-2953
Practice Address - Fax:251-447-2745
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL29376208VP0000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine