Provider Demographics
NPI:1285420067
Name:IBRAHIM, FADI (MD)
Entity type:Individual
Prefix:MR
First Name:FADI
Middle Name:
Last Name:IBRAHIM
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Gender:
Credentials:MD
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Mailing Address - Street 1:75 FRANCIS STREET
Mailing Address - Street 2:DEPARTMENT OF RADIOLOGY, BRIGHAM AND WOMEN'S HOSPITAL
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-732-6306
Mailing Address - Fax:617-732-6317
Practice Address - Street 1:75 FRANCIS STREET
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY, BRIGHAM AND WOMEN'S HOSPITAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-732-6306
Practice Address - Fax:617-732-6317
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
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Provider Licenses
StateLicense IDTaxonomies
MA30176962085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology