Provider Demographics
NPI:1881984359
Name:IBE, ALOYSIUS C (DRPH)
Entity type:Individual
Prefix:
First Name:ALOYSIUS
Middle Name:C
Last Name:IBE
Suffix:
Gender:M
Credentials:DRPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3935 ERDMAN AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-2004
Mailing Address - Country:US
Mailing Address - Phone:410-342-2606
Mailing Address - Fax:410-558-2643
Practice Address - Street 1:3935 ERDMAN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-2004
Practice Address - Country:US
Practice Address - Phone:410-342-2606
Practice Address - Fax:410-558-2643
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10893183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist