Individual
IDRISS IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
309 E COLLEGE DR, MARSHALL, MN 56258-2379
(507) 530-6028
Mailing address
1120 BIRCH ST APT 2, MARSHALL, MN 56258-1550
(507) 530-6028
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6251
MN
Other
Enumeration date
08/10/2015
Last updated
04/16/2020
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