Hazim Ibrahim, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

07001283A Issued in IN

Practice address

7527 Thoroughbred Dr Apt 3D
Fort Wayne, IN 46804

Phone

(440) 840-3692

NPI assigned

Jun 5, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1417337353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7527 THOROUGHBRED DR APT 3D",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042362",
            "telephone_number": "408-403-6924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7527 THOROUGHBRED DR APT 3D",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46804",
            "telephone_number": "440-840-3692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "HAZIM",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-05",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07001283A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Elizabeth Hyduk, PHARMD
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• I Care Home and Personal Care
• Saad M. Ibrahim, M.D., M.S.
• Payton R Ice, RBT
• Icoh LLC
• Maria U. Ijomanta, DPT
• Nnenna Ijomanta

• Podiatrist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Podiatrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.