Individual
DR. RADWAN A IBRAHIM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
211 S CHESTNUT ST, GASTONIA, NC 28054-7177
(704) 866-0101
(704) 866-0103
Mailing address
4593 WATERFORD DR NW, CONCORD, NC 28027-7041
(704) 866-0101
(704) 866-0103
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9701414
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891103L
—
NC
Enumeration date
09/14/2005
Last updated
07/08/2007
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