Frederick Tibuah

Primary specialty

Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X

License

243022 Issued in DE

Practice address

1601 Kirkwood Hwy
Wilmington, DE 19805-4917

Phone

(910) 343-5300

NPI assigned

Dec 4, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1518504075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 DARLING ST",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 KIRKWOOD HWY",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198054917",
            "telephone_number": "910-343-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBUAH",
        "first_name": "FREDERICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-04",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "DE",
            "license": "243022",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "DE",
            "license": "243022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "PAYAT50604321",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HIS",
            "affiliation": "N",
            "address_1": "1601 Kirkwood Hwy",
            "city": "Wilmington",
            "state": "DE",
            "country_code": "US",
            "postal_code": "198054917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vruti Thumar
• Ruth W Thuo, MSN
• Emma Nicole Thwaites
• Russell J. Tibbetts, D.D.S.
• Scott Tibbetts, DMD
• Tice Pediatric Physical Therapy LLC
• Lauren M. Tice, RD
• Lindsay C. Tice, PT
• Tigani Family Dentistry
• Kristin Mary Tigani-Taylor, D.D.S

• Clinical Pathology/Laboratory Medicine Physician in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Clinical Pathology/Laboratory Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.