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General NPI Number Information
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NPI Number | 1699262154
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Entity Type | Individual
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Provider Name | IBORO CHARLES UMANA PHD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2018
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 719 MANNING ST
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City | PHILADELPHIA
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State | PA
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Zip | 19106
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Country | US
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Telephone | 215-829-3561
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Fax |
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Provider Business Mailing Address
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Address Line | 719 MANNING ST BLDG 4TH
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City | PHILADELPHIA
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State | PA
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Zip | 19106
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Country | US
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Telephone | 215-829-3561
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 103889
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License Number State | GA
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