Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301054809 | MI |
Y | 2080P0214X | Pediatric Pulmonologist | 4301054809 | MI |
NPI | 1659314326 |
---|---|
Provider Name | Ibrahim Abdulhamid |
First Address | Detroit, MI 48201 |
Second Address | Detroit, MI 48201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 23/11/2015 |