Individual
DR. IBRAHIM A JAWAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20671 WILLIAMSBURG RD, DEARBORN HEIGHTS, MI 48127-2757
(313) 903-2100
(844) 225-2914
Mailing address
20671 WILLIAMSBURG RD, DEARBORN HEIGHTS, MI 48127-2757
(313) 903-2100
(844) 225-2914
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301044506
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023092616
—
MI
01
—
110241691
RR MEDICARE
MI
01
—
700F319250
BLUE SHIELD
MI
Enumeration date
12/06/2005
Last updated
10/21/2024
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