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NPI Code Detail

MEDICARE: DR. IBRAHIM IBRAHIM MD

MEDICARE: DR. IBRAHIM IBRAHIM MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1053254094
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IBRAHIM IBRAHIM MD
Provider Business Mailing Address
First Line : 3800 RESERVOIR RD NW
Second Line : DEPARTMENT OF SURGERY
City : WASHINGTON
State : DC
Zip : 20007-2113
Country : US
Telephone Number : 202-444-7106
Fax Number : 877-376-2418
Provider Business Practice Location Address
First Line : 3800 RESERVOIR RD NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20007-2113
Country : US
Telephone Number : 202-444-7106
Fax Number : 877-376-2418
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2026
Last Update Date : 04/13/2026

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