Ibetoh, Delores Ijeoma

Ibetoh, Delores Ijeoma is an individual health care provider with primary practice located at 3950 Austell Rd , Austell GA 30106-1121. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Ibetoh, Delores Ijeoma can be contacted via phone (770) 732-4035.

Contact Information

Primary practice address
3950 Austell Rd Austell GA 30106-1121
Phone: (770) 732-4035
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 66187 Georgia
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 44903 Tennessee
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 66187 Georgia

Profile Details

NPI number 1861613945
LBN Legal business name Ibetoh, Delores Ijeoma
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2007
Last updated Apr 22nd, 2021 - about 4 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 1861613945 NPPES
Tennessee MEDICAID 1514545
Tennessee MEDICAID 1861613945
Tennessee MEDICAID 1514660

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