Individual
DR. MOHD ELMUGTABA MUTASIM IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-0100
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D94361
MD
208M00000X
Hospitalist Physician
D94361
MD
Other
Enumeration date
03/28/2017
Last updated
05/07/2024
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