Individual
AUSTIN TARIBO DIKIBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
8116 GOOD LUCK RD STE 305, LANHAM, MD 20706-3508
(301) 552-1200
Mailing address
8116 GOOD LUCK RD STE 305, LANHAM, MD 20706-3508
(301) 552-1200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C07997
MD
Other
Enumeration date
04/06/2020
Last updated
09/24/2021
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