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Individual
MICHAEL A IMEVBORE
Active
Individual
MICHAEL A IMEVBORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
042335
CT
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
042335
CT
207RP1001X
Pulmonary Disease Physician
Primary
042335 CT
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001423350
—
CT
01
—
36951
CONTROLLED SUBSTANCE NO
CT
Enumeration date
10/06/2006
Last updated
03/07/2023
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