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General NPI Number Information
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NPI Number | 1962047159
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Entity Type | Organization
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Legal Business Name | TRIIBE MEDICAL LLC
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Dates
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Enumeration Date | 11/12/2019
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Last Update Date | 06/01/2021
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Provider Practice Location Address
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Address Line | 9500 MEDICAL CENTER DR STE 105
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City | LARGO
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State | MD
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Zip | 20774-3703
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Country | US
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Telephone | 301-615-4133
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Fax | 240-245-2918
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Provider Business Mailing Address
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Address Line | PO BOX 27996
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City | BELFAST
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State | ME
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Zip | 04915-2031
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Country | US
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Telephone | 301-615-4133
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Fax | 240-245-2918
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Authorized Official
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Title or Position | OWNER
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Name | ULOMA C IBE
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Credential | MD
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Telephone | 202-704-3010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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