Healthcare Provider Details

I. General information

NPI: 1477460756
Provider Name (Legal Business Name): IBM MEDICAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 RIGGINS RD
TALLAHASSEE FL
32308-5315
US

IV. Provider business mailing address

1019 N MONROE ST
TALLAHASSEE FL
32303-6144
US

V. Phone/Fax

Practice location:
  • Phone: 850-656-4800
  • Fax: 850-656-4892
Mailing address:
  • Phone: 850-656-4800
  • Fax: 850-656-4892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. SHYAMAL CHANDRA BIR
Title or Position: OWNER
Credential: MD
Phone: 318-207-3555