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General NPI Number Information
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NPI Number | 1609679737
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Entity Type | Individual
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Provider Name | IBRAHIM SHAMMAS MD
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Gender | Male
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Dates
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Enumeration Date | 04/01/2025
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 1430 TULANE AVE # 8050
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City | NEW ORLEANS
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State | LA
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Zip | 70112-2632
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Country | US
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Telephone | 504-988-7809
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Fax |
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Provider Business Mailing Address
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Address Line | 1204 17TH AVE NW APT 2
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City | ROCHESTER
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State | MN
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Zip | 55901-0252
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Country | US
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Telephone | 312-539-1512
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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