Provider Demographics
NPI:1013390236
Name:BAWAB, IBRAHIM TOUFIC (MD)
Entity Type:Individual
Prefix:DR
First Name:IBRAHIM
Middle Name:TOUFIC
Last Name:BAWAB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 HOME DEPOT DRIVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:SENECA
Mailing Address - State:PA
Mailing Address - Zip Code:16323-1044
Mailing Address - Country:US
Mailing Address - Phone:814-437-7266
Mailing Address - Fax:
Practice Address - Street 1:124 HOME DEPOT DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-8002
Practice Address - Country:US
Practice Address - Phone:814-657-8739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301107977207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology