Individual
IYABO A IBOAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1005 BELLEFONTAINE AVE, SUITE 100, LIMA, OH 45804-2851
(419) 227-5298
(419) 227-5879
Mailing address
121 W HIGH ST, LIMA, OH 45801-4340
(419) 998-4388
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2002014445
MO
207Q00000X
Family Medicine Physician
Primary
35092246
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09379834
—
MS
05
—
2902970
—
OH
Enumeration date
01/22/2006
Last updated
09/06/2011
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