Ibrahim, Mohamed M

Ibrahim, Mohamed M is an sole proprietor health care provider with primary practice located at 15 Elizabeth Dr , Lockport NY 14094-5226. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Pediatric Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Ibrahim, Mohamed M can be contacted via phone (716) 341-3983.

Contact Information

Primary practice address
15 Elizabeth Dr Lockport NY 14094-5226
Fax: (716) 433-6388
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 35087769 Ohio
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 35087769 Ohio

Profile Details

NPI number 1154379295
LBN Legal business name Ibrahim, Mohamed M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 4th, 2006
Last updated Jul 10th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154379295 NPPES
New York MEDICAID 02836482

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