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NPI Code Detail

MEDICARE: DR. IBRAHIM A MOURAD MD

MEDICARE: DR. IBRAHIM A MOURAD MD
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist Physician036-147746IL
2208M00000XHospitalist Physician2009021594MO
3207R00000XInternal Medicine Physician04-34405KS

General Provider Information

NPI Number : 1164497525
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IBRAHIM A MOURAD MD
Provider Business Mailing Address
First Line : 4500 MEMORIAL DR
Second Line :
City : BELLEVILLE
State : IL
Zip : 62226-5360
Country : US
Telephone Number : 618-257-6220
Fax Number : 618-257-6679
Provider Business Practice Location Address
First Line : 19550 E 39TH ST S
Second Line : SUITE 400
City : INDEPENDENCE
State : MO
Zip : 64057-2303
Country : US
Telephone Number : 816-254-4800
Fax Number : 816-254-4641
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2006
Last Update Date : 05/13/2026

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Directions to “ DR. IBRAHIM A MOURAD MD” Practice Location

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