Individual
ABRAHIM IMAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1665 S GREEN ST, TUPELO, MS 38804-6556
(662) 377-2189
(662) 377-2667
Mailing address
1665 S GREEN ST, TUPELO, MS 38804-6556
(662) 377-2189
(662) 377-2667
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO.3848
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2021
Last updated
10/30/2024
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