Ibach, Michael B

Ibach, Michael B is an individual health care provider with primary practice located at 1375 Roberts Dr Ste 204, Jacksonville Beach FL 32250-3210. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Ibach, Michael B can be contacted via phone (904) 247-0056.

Contact Information

Primary practice address
1375 Roberts Dr Ste 204 Jacksonville Beach FL 32250-3210
Phone: (904) 247-0056
Fax: (904) 241-0065
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 26687 Tennessee
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X ME67895 Florida

Profile Details

NPI number 1053362723
LBN Legal business name Ibach, Michael B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2006
Last updated May 24th, 2011 - about 13 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 1053362723 NPPES
Florida Other 14AW4 BCBS
Florida MEDICAID 003230300 BCBS

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