Individual
DR. IBRAHIM AL-SANOURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
4301075454
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
4301075454
MI
207RP1001X
Pulmonary Disease Physician
Primary
4301075451
MI
207RP1001X
Pulmonary Disease Physician
51402
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356452833
—
WI
Enumeration date
08/31/2006
Last updated
10/27/2020
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