Individual
GENA IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 LAFAYETTE AVE SE STE 4000, GRAND RAPIDS, MI 49503-4692
(616) 685-6922
Mailing address
300 LAFAYETTE AVE SE STE 4000, GRAND RAPIDS, MI 49503-4692
(616) 685-6922
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4351048380
MI
Other
Enumeration date
06/25/2021
Last updated
12/05/2022
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