Provider Demographics
NPI:1275136475
Name:IBE PC
Entity Type:Organization
Organization Name:IBE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ULOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:IBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-704-3010
Mailing Address - Street 1:9500 MEDICAL CENTER DR STE 105
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-3703
Mailing Address - Country:US
Mailing Address - Phone:301-615-4133
Mailing Address - Fax:240-245-2918
Practice Address - Street 1:9500 MEDICAL CENTER DR STE 105
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-3703
Practice Address - Country:US
Practice Address - Phone:301-615-4133
Practice Address - Fax:240-245-2918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty