Abdullahi Ibrahim Mohamed, MBBS | |
3301 N Sawgrass Way, Boise, ID 83704-4493 | |
(208) 375-0862 | |
Not Available |
Full Name | Abdullahi Ibrahim Mohamed |
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Gender | Male |
Speciality | Internal Medicine |
Location | 3301 N Sawgrass Way, Boise, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902368970 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | MRM-1805 (Idaho) | Secondary |
207R00000X | Internal Medicine | M-16579 (Idaho) | Primary |
Entity Name | St Lukes Clinic-treasure Valley Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 |
Mailing Address | Practice Location Address |
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Abdullahi Ibrahim Mohamed, MBBS 190 E Bannock St, Boise, ID 83712-6241 Ph: () - | Abdullahi Ibrahim Mohamed, MBBS 3301 N Sawgrass Way, Boise, ID 83704-4493 Ph: (208) 375-0862 |
Dr. Jennifer A Hofstra, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1055 N Curtis Road, Boise, ID 83706 Phone: 757-446-8920 Fax: 757-446-5242 | |
Dr. James Robert Polk, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-3104 | |
Dr. Michael Frederic Krug, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 190 E Bannock St, Boise, ID 83712 Phone: 208-381-5015 Fax: 208-381-1873 | |
Derrel V Walker, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 1055 N Curtis Road, Boise, ID 83706 Phone: 208-367-7350 Fax: 208-367-3951 | |
Dr. Janat E. O'donnell, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 500 W. Fort St., # 111, Boise, ID 83702 Phone: 208-422-1325 Fax: 208-422-1319 | |
Carl L Durning, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 6094 W Emerald St, Boise, ID 83704 Phone: 208-367-6575 Fax: 208-367-6597 | |
Dr. Christopher J Goulet, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 6259 W Emerald St, Boise, ID 83704 Phone: 208-489-1900 Fax: 208-375-5286 |