Individual
DR. NASRELDIN MOHAMED IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0287
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
335254
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1651
TEMPORARY LICENCE NUMBER
GA
Enumeration date
08/05/2007
Last updated
04/06/2023
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