Individual ProviderAhmed IbrahimInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4800 Alberta Ave, El Paso, TX 79905-2700(915) 799-4341PECOS EnrollmentBased on the most recent information from CMS, provider Ahmed Ibrahim is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1639481989Provider TypeIndividualFull NameIbrahim, AhmedTitleDr.CredentialMDGenderMaleSole ProprietorYesEnumeration Date7/1/2010Last Updated4/19/2021Contact InformationPractice LocationPractice Address4800 Alberta Ave, El Paso, TX 79905-2700Phone(915) 799-4341FaxUnlisted FaxMailing LocationMailing Address10318 Reserve Dr Apt 101, San Diego, CA 92127-3565PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense35.098819OhioCode207RC0000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense20592WisconsinProvider IdentifiersIDDescriptionIssuerID0066967DescriptionMedicaidIssuerUnlistedOhio