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NPI Code Detail

MEDICARE: IKECHUKWU ERIC IBEGBU MD

MEDICARE: IKECHUKWU ERIC IBEGBU MD
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
1207RG0100XGastroenterology Physician200401229NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00310404OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639154248
Entity Type Code : Individual
Provider Name (Legal Business Name) : IKECHUKWU ERIC IBEGBU MD
Provider Business Mailing Address
First Line : 4 JOSH CT
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-0052
Country : US
Telephone Number : 910-577-3636
Fax Number :
Provider Business Practice Location Address
First Line : 4 JOSH COURT
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-5253
Country : US
Telephone Number : 910-577-3636
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2005
Last Update Date : 03/02/2017

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