Provider Demographics
NPI:1467629436
Name:RIBAUDO, JOSEPH MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:RIBAUDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 BANK ST
Mailing Address - Street 2:STE 220
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1504
Mailing Address - Country:US
Mailing Address - Phone:301-330-6203
Mailing Address - Fax:301-330-6206
Practice Address - Street 1:2120 COWELL BLVD
Practice Address - Street 2:STE 142
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95618-7835
Practice Address - Country:US
Practice Address - Phone:301-330-6203
Practice Address - Fax:301-330-6206
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC42686207L00000X
NY246503-1207L00000X
LAMD010663207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology