Healthcare Provider Details

I. General information

NPI: 1043139306
Provider Name (Legal Business Name): IP HEALTHCARE PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10210 GUILFORD RD
JESSUP MD
20794-9528
US

IV. Provider business mailing address

10210 GUILFORD RD
JESSUP MD
20794-9528
US

V. Phone/Fax

Practice location:
  • Phone: 240-636-9891
  • Fax: 920-214-0986
Mailing address:
  • Phone: 240-636-9891
  • Fax: 920-214-0986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: HOI LENG IP
Title or Position: PHYSICIAN
Credential: MD
Phone: 443-432-9445