Ekanem, Ibanga Michael

Ekanem, Ibanga Michael is an individual health care provider with primary practice located at 100 Paducah Dr , New Martinsville WV 26155. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as his primary health care specialty. Ekanem, Ibanga Michael can be contacted via phone (304) 455-3611.

Contact Information

Primary practice address
100 Paducah Dr New Martinsville WV 26155
Phone: (304) 455-3611
Fax: (304) 455-1778
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 19922 West Virginia

Profile Details

NPI number 1710085824
LBN Legal business name Ekanem, Ibanga Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Apr 18th, 2022 - about 3 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 1710085824 NPPES
West Virginia MEDICAID 1801553000

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