Provider Demographics
NPI:1720246622
Name:EHIABOR, TIMOTHY OMENONYE (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:OMENONYE
Last Name:EHIABOR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:14201 LAUREL PARK DR
Mailing Address - Street 2:SUITE 102A
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5203
Mailing Address - Country:US
Mailing Address - Phone:301-490-6341
Mailing Address - Fax:301-490-6343
Practice Address - Street 1:14201 LAUREL PARK DR
Practice Address - Street 2:SUITE 102A
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5203
Practice Address - Country:US
Practice Address - Phone:301-490-6341
Practice Address - Fax:301-490-6343
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2023-11-10
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Provider Licenses
StateLicense IDTaxonomies
MDD71421207Q00000X
FLME0130609208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine