Provider Demographics
NPI:1851376529
Name:IBRADO, ANA M (MD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:M
Last Name:IBRADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 VARNUM ST. N.E.
Mailing Address - Street 2:PROVIDENCE HOSPITAL - EMERGENCY DEPARTMENT
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017
Mailing Address - Country:US
Mailing Address - Phone:202-269-7996
Mailing Address - Fax:
Practice Address - Street 1:1150 VARNUM ST. N.E.
Practice Address - Street 2:PROVIDENCE HOSPITAL - EMERGENCY DEPARTMENT
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017
Practice Address - Country:US
Practice Address - Phone:202-269-7996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD33012207P00000X
IN01083565A207P00000X
IL036151587207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00750848Medicare PIN
MD146493Y1ZMedicare PIN