Individual
ABDULLAHI IBRAHIM MOHAMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
3301 N SAWGRASS WAY, BOISE, ID 83704-4493
(208) 375-0862
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M-16579
ID
207R00000X
Internal Medicine Physician
MRM-1805
ID
Other
Enumeration date
04/01/2019
Last updated
07/21/2022
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