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NPI Code Detail

MEDICARE: IBRAHIM MASOUD

MEDICARE: IBRAHIM MASOUD
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
11223G0001XGeneral Practice Dentistry004003OH

General Provider Information

NPI Number : 1457818692
Entity Type Code : Individual
Provider Name (Legal Business Name) : IBRAHIM MASOUD
Provider Business Mailing Address
First Line : 4071 LEE RD STE 260
Second Line :
City : CLEVELAND
State : OH
Zip : 44128-2173
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4071 LEE RD STE 260
Second Line :
City : CLEVELAND
State : OH
Zip : 44128-2173
Country : US
Telephone Number : 727-877-9669
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2019
Last Update Date : 02/25/2019

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Directions to “ IBRAHIM MASOUD ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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