Healthcare Provider Details

I. General information

NPI: 1124816426
Provider Name (Legal Business Name): REEM IBRAHIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 UNIVERSITY HOSPITAL DR RM. MASTIN 212
MOBILE AL
36617
US

IV. Provider business mailing address

2451 UNIVERSITY HOSPITAL DR RM 212
MOBILE AL
36617-2300
US

V. Phone/Fax

Practice location:
  • Phone: 251-471-7117
  • Fax:
Mailing address:
  • Phone: 251-471-7117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberL.6679
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: