Provider Demographics
NPI:1578170973
Name:IBRAHIM, MAJDI M (PT)
Entity Type:Individual
Prefix:
First Name:MAJDI
Middle Name:M
Last Name:IBRAHIM
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 W 9 MILE RD STE D
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-1779
Mailing Address - Country:US
Mailing Address - Phone:248-951-9080
Mailing Address - Fax:
Practice Address - Street 1:641 W 9 MILE RD STE D
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-1779
Practice Address - Country:US
Practice Address - Phone:248-951-9080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist