Individual
DR. MOHAMED M IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15 ELIZABETH DR, LOCKPORT, NY 14094-5226
(716) 341-3983
(716) 433-6388
Mailing address
15 ELIZABETH DR, LOCKPORT, NY 14094-5226
(716) 341-3983
(716) 433-6388
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35087769
OH
2086S0120X
Pediatric Surgery Physician
35087769
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02836482
—
NY
Enumeration date
05/04/2006
Last updated
07/10/2012
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