Provider Demographics
NPI:1831381243
Name:IGBRE, ANN O (MD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:O
Last Name:IGBRE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1717
Mailing Address - Country:US
Mailing Address - Phone:404-364-7070
Mailing Address - Fax:410-339-7326
Practice Address - Street 1:3650 STEVE REYNOLDS BLVD
Practice Address - Street 2:KAISER PERMANENTE GWINNETT MEDICAL CENTER
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4506
Practice Address - Country:US
Practice Address - Phone:410-337-4500
Practice Address - Fax:410-339-7326
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2022-01-10
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Provider Licenses
StateLicense IDTaxonomies
VA0101249433207W00000X
MDD72164207W00000X
DEC7-0004368207W00000X
PAMT190630207W00000X
GA070301207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD043399300Medicaid