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NPI Code Detail

MEDICARE: ABRAHIM IMAM D.O.

MEDICARE: ABRAHIM IMAM D.O.
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1366392573
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABRAHIM IMAM D.O.
Provider Business Mailing Address
First Line : 3414 HARRISON AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4272
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2103 JENKS AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4511
Country : US
Telephone Number : 850-785-0085
Fax Number :
Authorized Official
Title or Position : CEO
Name : ABRAHIM IMAM
Credential : DO
Telephone Number : 256-617-0815
Provider Enumeration Date : 01/29/2026
Last Update Date : 01/29/2026

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