Provider Demographics
NPI:1790104628
Name:ZAMBRANO, IBARDO ALONSO I (MD)
Entity Type:Individual
Prefix:DR
First Name:IBARDO
Middle Name:ALONSO
Last Name:ZAMBRANO
Suffix:I
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 936857
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-5127
Mailing Address - Country:US
Mailing Address - Phone:910-662-8765
Mailing Address - Fax:910-362-9123
Practice Address - Street 1:1814 NEW HANOVER MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5350
Practice Address - Country:US
Practice Address - Phone:910-662-8765
Practice Address - Fax:910-362-9123
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT205760208800000X
NC201901591208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology