Organization
DIBOS-EDERY, P.A.
Active
Other names
Pablo E. Dibos, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
PABLO E. DIBOS M.D. (M.D.)
(410) 532-3710
Entity
Organization
Contact information
Practice address
5601 LOCH RAVEN BLVD, BALTIMORE, MD 21239-2905
(410) 532-3710
(410) 532-4405
Mailing address
10845 PHILADELPHIA RD, WHITE MARSH, MD 21162-1717
(410) 335-0008
(410) 335-1133
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
D0004683
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110238
JHHP
—
01
—
2788PE
CAREFIRST MARYLAND
MD
01
—
R251 001
CAREFIRST DC
DC
Enumeration date
08/27/2007
Last updated
08/27/2007
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