DIBOS-EDERY, P.A. (NPI# 1154514719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154514719 |
| Entity Type | Organization |
| Organization Name | DIBOS-EDERY, P.A. |
| Other Organization Name | PABLO E. DIBOS, M.D. |
| Practice Address |
5601 Loch Raven Blvd Baltimore MD 21239-2905 |
| Mailing Address |
10845 Philadelphia Rd White Marsh MD 21162-1717 |
| Practice Telephone | 4105323710 |
| Practice Fax Number | 4105324405 |
| Mailing Telephone | 4103350008 |
| Mailing Fax Number | 4103351133 |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2007-08-27 |
| Authorized Official Name | PABLO E. DIBOS (M.D.) |
| Authorized Official Telephone | 4105323710 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207U00000X | Nuclear Medicine | D0004683 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | CAREFIRST MARYLAND | 2788PE | 01 |
| DC | CAREFIRST DC | R251 001 | 01 |
| JHHP | 110238 | 01 |
| Other Name | Type Code |
|---|---|
| Pablo E. Dibos, M.D. | Former Legal Business Name - Organization |
| Street Address |
5601 LOCH RAVEN BLVD |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21239-2905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316940588 | Paul Byron Fowler | Specialist | 5601 Loch Raven Blvd, Baltimore, MD 21239-2905 | 2005-05-23 |
| 1992328017 | Kaitlin Lee | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-05-22 |
| 1023646692 | Akiko Rockers | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-03-30 |
| 1578199519 | Erica Wilson | Pharmacist | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-03-22 |
| 1154952497 | Kimberly Jo Jenko | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-01-27 |
| 1679103576 | Nerland Dimanche | Registered Nurse | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-01-20 |
| 1063058782 | Simcha Gratz | Nurse Practitioner | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2019-11-19 |
| 1548817737 | Christopher Burgess | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2019-08-22 |
| 1114571809 | Lauren Delmonico | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2019-07-30 |
| 1750943411 | Sana Tanveer Ahmed | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2019-07-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255809273 | Books of Color, LLC | Student in an Organized Health Care Education/Training Program | 1222 Walker Ave, Baltimore, MD 21239 | 2018-11-07 |
| 1902381353 | Brandon Wilson | Physician Assistant | 5601 Lochraven Blvd, Baltimore, MD 21239 | 2018-10-02 |
| 1629563879 | Ashley C Sayles | Nurse Practitioner | 5601 Loch Raven Blvd Ste 200, Baltimore, MD 21239 | 2018-06-28 |
| 1164940656 | Tarnisha Fitzgerald | Nurse Practitioner | 1601 East Belvedere Avenue, Baltimore, MD 21239 | 2017-09-05 |
| 1083153803 | J.pope & Associates, LLC | Counselor | 1800 E. Northern Pkwy #28031, Baltimore, MD 21239 | 2017-02-13 |
| 1417336017 | Mana Ali | Psychologist | 5601 Loch Raven Blvd Ste 406, Johns Hopkins Som Dept of Physical Med and Rehab, Baltimore, MD 21239 | 2015-05-28 |
| 1730597766 | Ramona Taylor-knox | Counselor | 1700 Meridian Drive, Suite 611, Baltimore, MD 21239 | 2014-07-22 |
| 1013259142 | Innovative Healing Solutions,llc | Social Worker | 1302 Silverthorne Rd, Baltimore, MD 21239 | 2013-03-27 |
| 1962744268 | Mohamad Hanouneh | Internal Medicine | 5601 Loch Raven Blvd Ste 3n, Baltimore, MD 21239 | 2013-03-25 |
| 1164713350 | Vanessa G Brown | Pharmacist | 5618 The Alameda, Baltimore, MD 21239 | 2011-04-22 |
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| Taxonomy Code | 207U00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Nuclear Medicine |
| A nuclear medicine specialist employs the properties of radioactive atoms and molecules in the diagnosis and treatment of disease and in research. Radiation detection and imaging instrument systems are used to detect disease as it changes the function and metabolism of normal cells, tissues and organs. A wide variety of diseases can be found in this way, usually before the structure of the organ involved by the disease can be seen to be abnormal by any other techniques. Early detection of coronary artery disease (including acute heart attack), early cancer detection and evaluation of the effect of tumor treatment, diagnosis of infection and inflammation anywhere in the body and early detection of blood clot in the lungs are all possible with these techniques. Unique forms of radioactive molecules can attack and kill cancer cells (e.g., lymphoma, thyroid cancer) or can relieve the severe pain of cancer that has spread to bone |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Nuclear Medicine, 2007. http://www.abnm.org/. A doctor of osteopathy was able to obtain a Certificate of Added Qualifications in the field of Nuclear Medicine. The Certificate is NO longer offered. - American Osteopathic Board of Nuclear Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Nuclear Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386808228 | Anthony Frank Fotenos | Nuclear Medicine | 601 N Caroline St Ste 3233, Baltimore, MD 21287-0006 | 2008-07-10 |
| 1548309875 | Lilja Bjork Solnes | Nuclear Medicine | 601 N Caroline St # 3245, Baltimore, MD 21287 | 2007-02-05 |
| 1578541488 | Sheikh Irfan Shafique | Nuclear Medicine | 1030 N Charles Street, Suite 100, Baltimore, MD 21201-5402 | 2006-01-03 |
| 1407288525 | Esther Mena Gonzalez | Nuclear Medicine | 601 N Caroline St, Suite 3233, Baltimore, MD 21287-0006 | 2013-07-31 |
| 1891050142 | Homeira Zahiri | Nuclear Medicine | 601 N Caroline St, Baltimore, MD 21287-0006 | 2012-07-11 |
| 1871753350 | Nigist M Zemariame | Nuclear Medicine | 22 S Greene St, Nuclear Medicine, Baltimore, MD 21201-1544 | 2008-06-10 |
| 1356489215 | Jaideep Singh Sohi | Nuclear Medicine | 601 N Caroline St, Jhoc 3223, Dept of Nuclear Medicine, Baltimore, MD 21287-0006 | 2007-02-02 |
| 1770519506 | Howard R Bates | Nuclear Medicine | 301 St. Paul Place, 3rd Floor, Nuclear Medicine, Baltimore, MD 21202-2102 | 2006-06-23 |
| 1306882998 | John T Salkeld | Nuclear Medicine | 301 Saint Paul Pl, Nuclear Med, Baltimore, MD 21202-2102 | 2006-06-21 |
| 1598706780 | Martin Gilbert Pomper | Nuclear Medicine | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2006-06-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.