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NPI Code Detail

MEDICARE: DR. IBRAHIM SALIM HAWATMEH M.D.

MEDICARE: DR. IBRAHIM SALIM HAWATMEH M.D.
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
1208800000XUrology Physician35812MO

General Provider Information

NPI Number : 1669407516
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IBRAHIM SALIM HAWATMEH M.D.
Provider Business Mailing Address
First Line : 12345 W BEND DR
Second Line : SUITE 200
City : SAINT LOUIS
State : MO
Zip : 63128-2104
Country : US
Telephone Number : 314-843-8000
Fax Number : 314-843-3004
Provider Business Practice Location Address
First Line : 12345 W BEND DR
Second Line : SUITE 200
City : SAINT LOUIS
State : MO
Zip : 63128-2104
Country : US
Telephone Number : 314-843-8000
Fax Number : 314-843-3004
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 02/18/2015

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