Individual
MICHAEL JOHN IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
428 S DURBIN ST STE 104, CASPER, WY 82601-2829
(307) 337-4284
(307) 224-3436
Mailing address
428 S DURBIN ST STE 104, CASPER, WY 82601-2829
(307) 337-4284
(307) 224-3436
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1343
WY
Other
Enumeration date
04/23/2025
Last updated
04/23/2025
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