Provider Demographics
NPI:1053115949
Name:IBRAHIM, AHMED BASHIR
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:BASHIR
Last Name:IBRAHIM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 E DUBLIN GRANVILLE RD STE 300Q
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-4413
Mailing Address - Country:US
Mailing Address - Phone:614-772-1997
Mailing Address - Fax:
Practice Address - Street 1:2700 E DUBLIN GRANVILLE RD STE 300Q
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-4413
Practice Address - Country:US
Practice Address - Phone:614-772-1997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372500000XNursing Service Related ProvidersChore Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant