| Kamal Ibrahim PC | |
|
7612 Gratiot Ave Detroit MI 48213-2822 | |
| (313) 397-1907 | |
| (313) 397-2125 |
| Full Name | Kamal Ibrahim PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 7612 Gratiot Ave, Detroit, Michigan |
| Authorized Official Name and Position | Kamal Musa Ibrahim (OWNER) |
| Authorized Official Contact | 3133971907 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kamal Ibrahim PC Po Box 871400 Canton MI 48187-7300 Ph: (313) 397-1907 | Kamal Ibrahim PC 7612 Gratiot Ave Detroit MI 48213-2822 Ph: (313) 397-1907 |
| NPI Number | 1558372458 |
|---|---|
| Provider Enumeration Date | 08/10/2006 |
| Last Update Date | 10/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558372458 | NPI | - | NPPES |
| 4713453 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301073747 (Michigan) | Primary |
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