Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 4301107977 | MI |
NPI | 1013390236 |
---|---|
Provider Name | Dr. Ibrahim Toufic Bawab |
First Address | Franklin, PA 16323-1044 |
Second Address | Franklin, PA 16323-1242 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2015 |
Last Update Date | 27/09/2019 |