Individual provider · Type 1 NPI
Ibrahim Azrag
Driver · Antioch, TN
NPI number
1073984985
Active
Practice location
3120 Shady Tree Ln
Antioch, TN 37013-2482
Fax (206) 888-4011
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Driver Primary | 172A00000X | 189601 (TN) |
Driver: A person employed to operate a motor vehicle as a carrier of persons or property.
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About NPI 1073984985
Ibrahim Azrag's National Provider Identifier is 1073984985, issued on Oct 19, 2015. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Antioch, TN. The record was last updated on Oct 19, 2015.