Individual
DR. GHAITH M IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
27560 HOOVER ROAD, HOOVER MEDICAL PLAZA, WARREN, MI 48093
(586) 757-6400
(586) 757-8400
Mailing address
PO BOX 1920, TROY, MI 48099-1920
(586) 757-6400
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
GI071013
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4813806
—
MI
Enumeration date
07/28/2006
Last updated
12/20/2012
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