Provider Demographics
NPI:1366262446
Name:GILBERT MBEO LLC
Entity type:Organization
Organization Name:GILBERT MBEO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:OCHIENG
Authorized Official - Last Name:MBEO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-839-4889
Mailing Address - Street 1:9121 ANSON WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5857
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 BRATTON DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-7825
Practice Address - Country:US
Practice Address - Phone:407-721-3460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology