Individual
DR. KAMAL MUSA IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6001 W OUTER DR, SUITE 320, DETROIT, MI 48235-2614
(313) 397-1907
Mailing address
PO BOX 871400, CANTON, MI 48187-7300
(313) 397-1907
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301073747
MI
208M00000X
Hospitalist Physician
Primary
51399
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1108249142
BCBS
MI
05
—
4713453
—
MI
05
—
473188110
—
MI
01
—
KI073747
BLUE SHIELD
MI
01
—
P00226506
RR MEDICARE
MI
Enumeration date
06/24/2006
Last updated
10/11/2022
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