Organization
KAMAL IBRAHIM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAMAL MUSA IBRAHIM MD (OWNER)
(313) 397-1907
Entity
Organization
Contact information
Practice address
7612 GRATIOT AVE, DETROIT, MI 48213-2822
(313) 397-1907
(313) 397-2125
Mailing address
PO BOX 871400, CANTON, MI 48187-7300
(313) 397-1907
(313) 397-2125
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301073747
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4713453
—
MI
Enumeration date
08/10/2006
Last updated
10/29/2015
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