Basic Information
Provider Information | |||||||||
NPI: | 1164580122 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | IBE | ||||||||
FirstName: | VERA | ||||||||
MiddleName: | I | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | ONYENORAH | ||||||||
OtherFirstName: | VERA | ||||||||
OtherMiddleName: | I | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | MD | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP | ||||||||
Address2: | 2101 E JEFFERSON ST PPQA MEDICARE UNIT 6 WEST | ||||||||
City: | ROCKVILLE | ||||||||
State: | MD | ||||||||
PostalCode: | 208524908 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3018162424 | ||||||||
FaxNumber: | 3018166308 | ||||||||
Practice Location | |||||||||
Address1: | 1221 MERCANTILE LN | ||||||||
Address2: | KAISER PERMANENTE LARGO MEDICAL CENTER | ||||||||
City: | LARGO | ||||||||
State: | MD | ||||||||
PostalCode: | 207745374 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3016185500 | ||||||||
FaxNumber: | 3016185673 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 12/04/2006 | ||||||||
LastUpdateDate: | 02/08/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 02/08/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | D63778 | MD | Y |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |   | 207V00000X | MD035055 | DC | N |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |   |
No ID Information.