Provider Demographics
NPI:1831238013
Name:INEGBENIJIE, CHRISTIAN INEGBENOVIA (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:INEGBENOVIA
Last Name:INEGBENIJIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 HADLEY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04654-5108
Mailing Address - Country:US
Mailing Address - Phone:207-255-3204
Mailing Address - Fax:
Practice Address - Street 1:36 HADLEY LAKE RD
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:ME
Practice Address - Zip Code:04654-5108
Practice Address - Country:US
Practice Address - Phone:207-255-3204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01061596A207V00000X
ME017500207VG0400X
IL036.117874207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics