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1023698131
MOHAMAD IBRAHIM ITANI
DETROIT, MI
NPI
1023698131
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: MI 4351048223)
Enumeration Date
2021-04-12
Last Update Date
2021-05-06
Business Address
Dr. MOHAMAD IBRAHIM ITANI MD
4201 SAINT ANTOINE ST # 9
DETROIT, MI 48201-2153
Phone number: 313-745-6047
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Mailing Address
Dr. MOHAMAD IBRAHIM ITANI MD
10 N CALVERT ST UNIT 914
BALTIMORE, MD 21202-4184
Phone number: 443-467-4149
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