Ghaith M Ibrahim MD PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

GHAITH M IBRAHIM MD PC

Practice address

27560 Hoover Rd
Warren, MI 48093-4505

Phone

(586) 757-6400

Fax

(586) 575-8400

NPI assigned

Aug 6, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marylou Zupko

Title

Medical Biller

Phone

(586) 757-6400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1962693804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27560 HOOVER RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480934505",
            "telephone_number": "586-757-6400",
            "fax_number": "586-575-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27560 HOOVER RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480934505",
            "telephone_number": "586-757-6400",
            "fax_number": "586-575-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GHAITH M IBRAHIM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ZUPKO",
        "authorized_official_first_name": "MARYLOU",
        "authorized_official_title_or_position": "MEDICAL BILLER",
        "authorized_official_telephone_number": "586-757-6400"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.