Ibrahim, Fahim K

Ibrahim, Fahim K is an sole proprietor health care provider with primary practice located at 4190 24Th Ave Suite 204, Fort Gratiot MI 48059-3882. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Ibrahim, Fahim K can be contacted via phone (810) 989-7702.

Contact Information

Primary practice address
4190 24Th Ave Suite 204 Fort Gratiot MI 48059-3882
Fax: (810) 989-7703
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X FI067033 Michigan

Profile Details

NPI number 1376611251
LBN Legal business name Ibrahim, Fahim K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 1st, 2006
Last updated Oct 20th, 2011 - about 15 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 1376611251 NPPES
Michigan MEDICAID 3350530

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