Individual
DR. LAMIS WAHID IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
615 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-8209
(423) 930-8337
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 439-7280
(423) 979-4134
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
45997
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1520587
—
TN
01
—
3714470
GROUP MEDICARE
TN
Enumeration date
10/09/2007
Last updated
01/18/2024
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