MEDICARE: AHMED BASHIR IBRAHIM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	372500000X	Chore Provider
2	3747P1801X	Personal Care Attendant
3	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1053115949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHMED BASHIR IBRAHIM

Provider Business Mailing Address
First Line	:	2700 E DUBLIN GRANVILLE RD STE 300Q
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-4413
Country	:	US
Telephone Number	:	614-772-1997
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 E DUBLIN GRANVILLE RD STE 300Q
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-4413
Country	:	US
Telephone Number	:	614-772-1997
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2025
Last Update Date	:	04/01/2025

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