Organization
MED-VAR SURGERY, PLLC
Active
Other names
MohamedIbrahim,MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMED M IBRAHIM MD (SURGICAL DIRECTOR)
(716) 341-3983
Entity
Organization
Contact information
Practice address
15 ELIZABETH DR, LOCKPORT, NY 14094-5226
(716) 341-3983
(716) 433-6388
Mailing address
15 ELIZABETH DR, LOCKPORT, NY 14094-5226
(716) 341-3983
(716) 433-6388
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
242348
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02836482
—
NY
Enumeration date
07/10/2012
Last updated
07/10/2012
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