Individual
AMJAD IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1355 BOGUE ST, EAST LANSING, MI 48824-6207
(800) 605-6424
Mailing address
1355 BOGUE ST, EAST LANSING, MI 48824-6207
(800) 605-6424
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MI
Other
Enumeration date
09/05/2025
Last updated
10/22/2025
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