Provider Demographics
NPI:1487396404
Name:IBEH, CLIFF-LAWRENCE NNAEMEKA (MD)
Entity type:Individual
Prefix:DR
First Name:CLIFF-LAWRENCE
Middle Name:NNAEMEKA
Last Name:IBEH
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 1:8169 WATERFORD CIR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-5124
Mailing Address - Country:US
Mailing Address - Phone:901-555-5555
Mailing Address - Fax:
Practice Address - Street 1:8169 WATERFORD CIR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-5124
Practice Address - Country:US
Practice Address - Phone:901-555-5555
Practice Address - Fax:901-448-0404
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program