# CHUKWUMA EBO,M.D.,PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043541253
- **Authorized official:** DR. CHUWUMA EBO (PRESIDENT)
- **Authorized official phone:** (410) 391-6996

## Contact information

- **Practice address:** 1124 MACE AVE, BALTIMORE, MD 21221-3315
- **Practice address phone:** (410) 391-6996
- **Practice address fax:** (410) 687-6877
- **Mailing address:** 1124 MACE AVE, BALTIMORE, MD 21221-3315
- **Mailing address phone:** (410) 391-6996
- **Mailing address fax:** (410) 687-6877

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | D0061907 | MD | Yes |

## Other

- **Enumeration date:** 01/28/2010
- **Last updated:** 01/28/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 407505600 | — | MD |