Organization
FIKRY F IBRAHIM MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FIKRY F IBRAHIM MD (OWNER)
(313) 886-0006
Entity
Organization
Contact information
Practice address
20825 MACK AVE, GROSSE POINTE WOODS, MI 48236-1485
(313) 886-0006
(313) 886-8523
Mailing address
20825 MACK AVE, GROSSE POINTE WOODS, MI 48236-1485
(313) 886-0006
(313) 886-8523
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301031520
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101375432
—
MI
01
—
1105260481
BLUECROSS LICENSE
MI
Enumeration date
05/08/2007
Last updated
06/13/2011
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