Individual
DR. MAUREEN ZIBOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
69045 M 62 STE B, EDWARDSBURG, MI 49112-9168
(574) 968-4100
(574) 968-4125
Mailing address
69045 M 62 STE B, EDWARDSBURG, MI 49112-9168
(574) 968-4100
(574) 968-4125
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01045545A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000532035
ANTHEM
IN
05
—
200046830
—
IN
05
—
200046830A
—
IN
Enumeration date
06/26/2006
Last updated
10/10/2018
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