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General NPI Number Information
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NPI Number | 1851454524
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Entity Type | Organization
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Legal Business Name | RIMA JIBALY M.D. , P.C
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Dates
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Enumeration Date | 12/17/2006
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Last Update Date | 01/04/2010
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Provider Practice Location Address
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Address Line | 1123 VILLA LINDE CT SUITE 38
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City | FLINT
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State | MI
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Zip | 48532-3410
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Country | US
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Telephone | 810-733-7221
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Fax | 810-733-7280
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Provider Business Mailing Address
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Address Line | 1123 VILLA LINDE CT SUITE 38
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City | FLINT
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State | MI
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Zip | 48532-3410
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Country | US
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Telephone | 810-733-7221
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Fax | 810-733-7280
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RIMA JIBALY
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Credential | M.D, B.S
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Telephone | 810-691-0171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 4301069514
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License Number State | MI
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