Ibazebo, Wesley Robert

Ibazebo, Wesley Robert is an individual health care provider with primary practice located at 1130 N Church St Ste 100 , Greensboro NC 27401-1041. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Ibazebo, Wesley Robert can be contacted via phone (336) 375-2300.

Contact Information

Primary practice address
1130 N Church St Ste 100 Greensboro NC 27401-1041
Phone: (336) 375-2300
Fax: (336) 375-2313
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 2010-00747 North Carolina

Profile Details

NPI number 1700091451
LBN Legal business name Ibazebo, Wesley Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 14th, 2007
Last updated Aug 3rd, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700091451 NPPES
North Carolina MEDICAID 5914849

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