| Iman Ibrahim MD PLLC | |
|
4320 Seminary Rd Alexandria VA 22304-1535 | |
| (703) 504-3000 | |
| Not Available |
| Full Name | Iman Ibrahim MD PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 4320 Seminary Rd, Alexandria, Virginia |
| Authorized Official Name and Position | Iman Mohamoud Ibrahim (OWNER) |
| Authorized Official Contact | 6467149310 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iman Ibrahim MD PLLC Po Box 333 Fairfax Station VA 22039-0333 Ph: (646) 714-9310 | Iman Ibrahim MD PLLC 4320 Seminary Rd Alexandria VA 22304-1535 Ph: (703) 504-3000 |
| NPI Number | 1669201752 |
|---|---|
| Provider Enumeration Date | 07/29/2024 |
| Last Update Date | 07/29/2024 |
| Certification Date | 07/29/2024 |
| Medicare PECOS PAC ID | 4688111057 |
|---|---|
| Medicare Enrollment ID | O20240802001150 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669201752 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Iman M Ibrahim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932406816 PECOS PAC ID: 0143476218 Enrollment ID: I20170929000058 |
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