Healthcare Provider Details

I. General information

NPI: 1215653621
Provider Name (Legal Business Name): MRS. HALIMA BUHARI SIBEDWO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2022
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3308 ALTAIR LN
UPPER MARLBORO MD
20774-3550
US

IV. Provider business mailing address

3308 ALTAIR LN
UPPER MARLBORO MD
20774-3550
US

V. Phone/Fax

Practice location:
  • Phone: 412-526-6392
  • Fax:
Mailing address:
  • Phone: 412-526-6392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN1049071
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR251838
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: