Individual provider · Type 1 NPI

Maryam Khalil Ibrahim, MD

Student in an Organized Health Care Education/Training Program · Boston, MA

NPI number 1154943157 Active · reactivated Feb 17, 2022

Practice location

55 Fruit St
Boston, MA 02114

Call (617) 724-4133 Map

Mailing address

1 Emerson Place, Apt 4P
Boston, MA 02114

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1154943157

Maryam Khalil Ibrahim, MD's National Provider Identifier is 1154943157, issued on May 12, 2020. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Boston, MA. The record was last updated on Feb 18, 2022.