Individual
FREDERICK TIBUAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1601 KIRKWOOD HWY, WILMINGTON, DE 19805-4917
(910) 343-5300
Mailing address
162 DARLING ST, NEWARK, DE 19702-3761
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
243022
DE
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
243022
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PAYAT50604321
BLUECROSS BLUESHIELD
—
Enumeration date
12/04/2019
Last updated
12/04/2019
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