Healthcare Provider Details

I. General information

NPI: 1558367110
Provider Name (Legal Business Name): IBRAHIM SBEITAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 11/23/2024
Certification Date: 11/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

337 SOMERSET STREET UPMC HILLMAN CANCER CENTER
JOHNSTOWN PA
15901-2541
US

IV. Provider business mailing address

337 SOMERSET ST
JOHNSTOWN PA
15901-2541
US

V. Phone/Fax

Practice location:
  • Phone: 814-534-4724
  • Fax:
Mailing address:
  • Phone: 814-534-4724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD057321L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: