Ibrahim, Radwan A

Ibrahim, Radwan A is an individual health care provider with primary practice located at 211 S Chestnut St , Gastonia NC 28054-7177. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Ibrahim, Radwan A can be contacted via phone (704) 866-0101.

Contact Information

Primary practice address
211 S Chestnut St Gastonia NC 28054-7177
Fax: (704) 866-0103
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 9701414 North Carolina

Profile Details

NPI number 1497740682
LBN Legal business name Ibrahim, Radwan A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2005
Last updated Jul 8th, 2007 - about 17 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 1497740682 NPPES
North Carolina MEDICAID 891103L

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