Individual
IBRAHIM SULAIMAN HEMAADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7600 MONTGOMERY BLVD NE APT 1065, ALBUQUERQUE, NM 87109-1523
(602) 751-1699
Mailing address
6406 W WINSLOW AVE, PHOENIX, AZ 85043-7705
(602) 751-1699
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
D02184121
AZ
Other
Enumeration date
01/14/2020
Last updated
01/14/2020
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