Provider Demographics
NPI:1174727739
Name:CHEBELEU, LIA ANA (MD)
Entity type:Individual
Prefix:DR
First Name:LIA
Middle Name:ANA
Last Name:CHEBELEU
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:PO BOX 912042
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84791-2042
Mailing Address - Country:US
Mailing Address - Phone:385-203-0246
Mailing Address - Fax:385-203-0245
Practice Address - Street 1:691 E 400 N, STE. 110
Practice Address - Street 2:
Practice Address - City:VINEYARD
Practice Address - State:UT
Practice Address - Zip Code:84058-8405
Practice Address - Country:US
Practice Address - Phone:385-203-0246
Practice Address - Fax:385-203-0245
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0023301207R00000X
UT8039433-12052084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
3295959803OtherMYUTMB 3295959803-COMMERCIAL NUMBER