Provider Demographics
NPI:1184344152
Name:SULIEMAN, IBNOUF IBNOUF SULIEMAN (MD)
Entity type:Individual
Prefix:
First Name:IBNOUF
Middle Name:IBNOUF SULIEMAN
Last Name:SULIEMAN
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 1:1025 WALNUT STREET
Mailing Address - Street 2:COLLEGE BUILDING SUITE 605
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107
Mailing Address - Country:US
Mailing Address - Phone:215-955-5909
Mailing Address - Fax:215-923-1420
Practice Address - Street 1:1101 LUDLOW ST APT 1410
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4271
Practice Address - Country:US
Practice Address - Phone:267-584-6682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PALT000943204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery