| Dr Timothy Omenonye Ehiabor, MD | |
|
14201 Laurel Park Dr, Suite 102a, Laurel, MD 20707-5203 | |
| (301) 490-6341 | |
| (301) 490-6343 |
| Full Name | Dr Timothy Omenonye Ehiabor |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 18 Years |
| Location | 14201 Laurel Park Dr, Laurel, Maryland |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720246622 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME0130609 (Florida) | Secondary |
| 207Q00000X | Family Medicine | D71421 (Maryland) | Secondary |
| 208M00000X | Hospitalist | ME0130609 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Sacred Heart Hospital | Pensacola, FL | Hospital |
| Ascension Sacred Heart Bay | Panama city, FL | Hospital |
| Ascension Sacred Heart Gulf | Port saint joe, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hni Hospital Services Of Florida Llc | 0244661353 | 53 |
| Galen Inpatient Physicians Pc | 3678464633 | 692 |
| Entity Name | Sacred Heart Health System, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902857352 PECOS PAC ID: 5799763074 Enrollment ID: O20040713000147 |
| Entity Name | Hospital Physician Services Of Florida Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558718635 PECOS PAC ID: 7012201965 Enrollment ID: O20160816000476 |
| Entity Name | Hni Medical Services Of Florida, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679048284 PECOS PAC ID: 7517202112 Enrollment ID: O20190102000426 |
| Entity Name | Hni Hospital Services Of Florida Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144851411 PECOS PAC ID: 0244661353 Enrollment ID: O20200505001799 |
| Entity Name | Pensacola Hospitalist Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487254140 PECOS PAC ID: 5395159818 Enrollment ID: O20210125001604 |
| Entity Name | Hospital Medicine Services Of Fl, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710684857 PECOS PAC ID: 9234596743 Enrollment ID: O20230526001457 |
| Entity Name | Galen Inpatient Physicians Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205614336 PECOS PAC ID: 3678464633 Enrollment ID: O20231116000854 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Timothy Omenonye Ehiabor, MD 14201 Laurel Park Dr, Suite 102a, Laurel, MD 20707-5203 Ph: (301) 490-6341 | Dr Timothy Omenonye Ehiabor, MD 14201 Laurel Park Dr, Suite 102a, Laurel, MD 20707-5203 Ph: (301) 490-6341 |
Colleen Michelle Wallace, M.D. Hospitalist Medicare: Medicare Enrolled Practice Location: 14113 Baltimore Ave Ste B, Laurel, MD 20707 Phone: 240-360-5723 |