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General NPI Number Information
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NPI Number | 1255578373
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Entity Type | Individual
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Provider Name | IBRAHIM DUQUM BDS, MS
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Gender | Male
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Dates
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Enumeration Date | 01/12/2009
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Last Update Date | 01/12/2009
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Provider Practice Location Address
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Address Line | 101 BRAUER HALL CB 7450
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City | CHAPEL HILL
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State | NC
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Zip | 27599-0001
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Country | US
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Telephone | 919-966-1221
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Fax |
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Provider Business Mailing Address
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Address Line | 101 BRAUER HALL CB 7450
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City | CHAPEL HILL
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State | NC
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Zip | 27599-0001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 0090
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 2640
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License Number State | ZZ
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