Individual
MANAR S IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1501 S WALDRON RD, STE 100, FORT SMITH, AR 72903-2574
(479) 709-7337
(479) 709-7461
Mailing address
PO BOX 402330, ATLANTA, GA 30384-2330
(479) 709-7399
(479) 709-7053
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
E0451
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100224660A
—
OK
05
—
127853001
—
AR
Enumeration date
10/05/2005
Last updated
08/13/2010
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