Individual
OMAR A IBRAHIMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
L-232692
MA
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
049530
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508061128
—
CT
Enumeration date
06/15/2007
Last updated
05/13/2025
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