Organization
CHUKWUMA EBO,M.D.,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHUWUMA EBO (PRESIDENT)
(410) 391-6996
Entity
Organization
Contact information
Practice address
1124 MACE AVE, BALTIMORE, MD 21221-3315
(410) 391-6996
(410) 687-6877
Mailing address
1124 MACE AVE, BALTIMORE, MD 21221-3315
(410) 391-6996
(410) 687-6877
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0061907
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
407505600
—
MD
Enumeration date
01/28/2010
Last updated
01/28/2010
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