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Individual

DR. THEODORE E IGWEBE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6327 MORNING DEW CT, CLARKSVILLE, MD 21029-1150
(240) 731-4872
(301) 972-2057
Mailing address
2401 RESEARCH BLVD, 350, ROCKVILLE, MD 20850-3215
(240) 731-4872
(301) 972-2057

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
D0052927
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0J43
BCBSMD
MD
01
110178865
RAILROAD MEDICARE
05
203803000
MD
01
4483
BCBSNCA
DC
Enumeration date
08/15/2005
Last updated
08/02/2012
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