Individual
IBRAHIM B DAGHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
24 CROWN RIDGE RD, WELLESLEY, MA 02482-4635
(781) 400-1020
Mailing address
24 CROWN RIDGE RD, WELLESLEY, MA 02482-4635
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
160124
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160124
LICENSE #
MA
Enumeration date
10/26/2007
Last updated
10/26/2007
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