MEDICARE: IBE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1275136475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IBE PC

Provider Business Mailing Address
First Line	:	9500 MEDICAL CENTER DR STE 105
Second Line	:
City	:	LARGO
State	:	MD
Zip	:	20774-3703
Country	:	US
Telephone Number	:	301-615-4133
Fax Number	:	240-245-2918

Provider Business Practice Location Address
First Line	:	9500 MEDICAL CENTER DR STE 105
Second Line	:
City	:	LARGO
State	:	MD
Zip	:	20774-3703
Country	:	US
Telephone Number	:	301-615-4133
Fax Number	:	240-245-2918

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ULOMA IBE
Credential	:	MD
Telephone Number	:	202-704-3010

Provider Enumeration Date	:	11/19/2020
Last Update Date	:	08/20/2021

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Directions to “IBE PC ” Practice Location

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