Individual
IBRAHEM SALLOUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
164 SUMMIT AVE, PROVIDENCE, RI 02906-2853
(401) 793-4489
(401) 793-4047
Mailing address
825 CHALKSTONE AVE, GRADUATE MEDICAL EDUCATION, PROVIDENCE, RI 02908-4728
(401) 588-4001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LP02361
RI
207R00000X
Internal Medicine Physician
Primary
MD14622
RI
Other
Enumeration date
07/02/2011
Last updated
10/23/2020
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