Individual
FAHIM K IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4190 24TH AVE, SUITE 204, FORT GRATIOT, MI 48059-3882
(810) 989-7702
(810) 989-7703
Mailing address
4190 24TH AVE, SUITE 204, FORT GRATIOT, MI 48059-3882
(810) 989-7702
(810) 989-7703
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
FI067033
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3350530
—
MI
Enumeration date
12/01/2006
Last updated
10/20/2011
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