Ibia, Itoro

Ibia, Itoro is an individual health care provider with primary practice located at 11701 Bowman Green Dr , Reston VA 20190-3573. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Ibia, Itoro can be contacted via phone (703) 707-9777.

Contact Information

Primary practice address
11701 Bowman Green Dr Reston VA 20190-3573
Phone: (703) 707-9777
Fax: (703) 707-0690
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 0101223034 Virginia
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 0101223034 Virginia

Profile Details

NPI number 1356338206
LBN Legal business name Ibia, Itoro
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2005
Last updated Jul 8th, 2007 - about 19 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1356338206 NPPES
Other F480-0001 CARE FIRST BCBS ID
Other 2037353 CARE FIRST BCBS ID
Other 466688 CARE FIRST BCBS ID
Other 7267195 CARE FIRST BCBS ID

Popular Providers