Individual
DR. IHAB J. IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 JEFFERSON BARRACKS DR, SAINT LOUIS, MO 63125-4181
(314) 652-4100
(314) 845-5077
Mailing address
1 JEFFERSON BARRACKS DR, SAINT LOUIS, MO 63125-4181
(314) 652-4100
(314) 845-5077
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
MA78363
NJ
208VP0014X
Interventional Pain Medicine Physician
Primary
MD.14699R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0188093
—
NJ
01
—
146829
MEDICARE ID-TYPE UNSPECIFIED
NJ
Enumeration date
06/06/2006
Last updated
11/21/2025
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