Healthcare Provider Details

I. General information

NPI: 1841124070
Provider Name (Legal Business Name): ABRAHIM IMAM D.O.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2103 JENKS AVE
PANAMA CITY FL
32405-4511
US

IV. Provider business mailing address

2103 JENKS AVE
PANAMA CITY FL
32405-4511
US

V. Phone/Fax

Practice location:
  • Phone: 850-785-0085
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ABRAHIM IMAM
Title or Position: OWNER
Credential: DO
Phone: 256-617-0815