Individual
RONNIE IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-2000
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 726-2000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
291108
MA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
291108
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2018
Last updated
07/13/2022
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