Iman Ibrahim Md Pllc | |
4320 Seminary Rd Alexandria VA 22304-1535 | |
(703) 504-3000 | |
Not Available |
Full Name | Iman Ibrahim Md Pllc |
---|---|
Speciality | Internal Medicine |
Location | 4320 Seminary Rd, Alexandria, Virginia |
Authorized Official Name and Position | Iman Mohamoud Ibrahim (OWNER) |
Authorized Official Contact | 6467149310 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Iman Ibrahim Md Pllc Po Box 333 Fairfax Station VA 22039-0333 Ph: (646) 714-9310 | Iman Ibrahim Md Pllc 4320 Seminary Rd Alexandria VA 22304-1535 Ph: (703) 504-3000 |
NPI Number | 1669201752 |
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Provider Enumeration Date | 07/29/2024 |
Last Update Date | 07/29/2024 |
Medicare PECOS PAC ID | 4688111057 |
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Medicare Enrollment ID | O20240802001150 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669201752 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Iman M Ibrahim |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1932406816 PECOS PAC ID: 0143476218 Enrollment ID: I20170929000058 |
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