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NPI Code Detail

MEDICARE: AHMED IBRAHIM

MEDICARE: AHMED IBRAHIM
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
1208M00000XHospitalist Physician22574ND
2207R00000XInternal Medicine Physician35126FL
3390200000XStudent in an Organized Health Care Education/Training Program35126FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A30036948OTHERPASSPORT

General Provider Information

NPI Number : 1528794609
Entity Type Code : Individual
Provider Name (Legal Business Name) : AHMED IBRAHIM
Provider Business Mailing Address
First Line : PO BOX 5074
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57117-5074
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5225 23RD AVE S
Second Line :
City : FARGO
State : ND
Zip : 58104-7927
Country : US
Telephone Number : 701-417-2575
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2022
Last Update Date : 12/08/2025

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Directions to “ AHMED IBRAHIM ” Practice Location

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