Individual
JAMAL AHMAD IBDAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
2005016790
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
199404
BLUE SHIELD/BLUE CHOICE
MO
05
—
207486408
—
MO
01
—
712031
HEALTHLINK
MO
Enumeration date
05/05/2006
Last updated
09/02/2022
Update your record
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