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General NPI Number Information
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NPI Number | 1568338358
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Entity Type | Individual
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Provider Name | SAMIRA ESAM ELBADAWI EBRAHIM MD
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Gender | Female
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Dates
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Enumeration Date | 10/16/2025
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 701 W FOREVERGREEN RD
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City | NORTH LIBERTY
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State | IA
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Zip | 52317-9848
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Country | US
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Telephone | 319-353-7722
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Fax |
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Provider Business Mailing Address
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Address Line | 20 CHERRY CT APT 1
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City | NORTH LIBERTY
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State | IA
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Zip | 52317-9003
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Country | US
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Telephone | 202-729-0758
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Fax | 202-729-0758
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | R-13352
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License Number State | IA
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