Individual
DR. IBRAHIM A FEYISSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
619 N PROVIDENCE RD, COLUMBIA, MO 65203-4355
(573) 234-1070
(573) 818-1342
Mailing address
2401 W BROADWAY APT 824, COLUMBIA, MO 65203-7620
(240) 839-8224
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2023038187
MO
Other
Enumeration date
10/14/2024
Last updated
10/14/2024
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