Individual
HISHAM IBRAHIM AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1457 SUNCREST DR, LAPEER, MI 48446-1151
(810) 245-3629
(810) 245-3640
Mailing address
1457 SUNCREST DR, LAPEER, MI 48446-1151
(810) 245-3629
(810) 245-3640
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301076402
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104412112
BCBSM
MI
05
—
459579 10
—
MI
Enumeration date
07/26/2006
Last updated
01/23/2014
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