Individual
MOHAMMED IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3577 W 13 MILE RD STE 103, ROYAL OAK, MI 48073-6710
(248) 288-4500
(248) 288-0450
Mailing address
29992 NORTHWESTERN HWY STE C, FARMINGTON HILLS, MI 48334-3292
(248) 851-1430
(248) 851-5182
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
4301081380
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891701082
—
MI
01
—
MI4989559
MEDICARE PTAN
MI
Enumeration date
07/31/2006
Last updated
04/25/2019
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