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General NPI Number Information
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NPI Number | 1366392573
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Entity Type | Organization
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Legal Business Name | ABRAHIM IMAM D.O.
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 2103 JENKS AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4511
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Country | US
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Telephone | 850-785-0085
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Fax |
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Provider Business Mailing Address
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Address Line | 3414 HARRISON AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4272
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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 | CEO
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Name | ABRAHIM IMAM
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Credential | DO
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Telephone | 256-617-0815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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