Healthcare Provider Details

I. General information

NPI: 1881023893
Provider Name (Legal Business Name): CHRISTOPHER CHIBAYERE CNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2013
Last Update Date: 11/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 E BALTIMORE ST
TANEYTOWN MD
21787-2223
US

IV. Provider business mailing address

313 E BALTIMORE ST
TANEYTOWN MD
21787-2223
US

V. Phone/Fax

Practice location:
  • Phone: 410-868-7167
  • Fax:
Mailing address:
  • Phone: 410-868-7167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberA00058970
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: