Individual
JOHN-MINA IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-1553
Mailing address
1598 OLD CHATHAM DR, BLOOMFIELD HILLS, MI 48304-1040
(248) 703-5659
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301086042
MI
Other
Enumeration date
06/14/2007
Last updated
07/08/2007
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