Ahmad M. Ibrahimbacha (NPI# 1043266752, PAC ID# 3779663018) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PULMONARY DISEASE.
| Nation Provider ID (NPI) | 1043266752 |
| PAC ID by PECOS | 3779663018 |
| Professional Enrollment ID | I20100922000075 |
| Full Name | Ahmad M. Ibrahimbacha |
| Organization Legal Name | BRADLEY-POLK WALK-IN CLINIC |
| Address |
119 White Water Dr Ocoee TN 37361-3645 |
| Phone Number | 4232999435 |
| Gender | M |
| Graduation Year | 1982 |
| Primary Specialty | PULMONARY DISEASE |
| Secondary Specialties | SLEEP MEDICINE |
| Group Practice PAC ID | 0547404931 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440185 | TENNOVA HEALTH CARE-CLEVELAND |
| 441310 | RHEA MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 110 Dunhill Place Nw, Cleveland, TN 37311-3883 | 4234762212 | BLUE RIDGE PULMONARY MEDICINE, PC |
| 7794 Rhea County Hwy, Suite 103, Dayton, TN 37321-5981 | 4234762212 | BLUE RIDGE PULMONARY MEDICINE, PC |
| 119 White Water Dr, Ocoee, TN 37361-3645 | 4232999435 | BRADLEY-POLK WALK-IN CLINIC |
| Organization Legal Name | BRADLEY-POLK WALK-IN CLINIC |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tami Brehen | Nurse Practitioner | Bradley-polk Walk-in Clinic | 119 White Water Dr, Ocoee, TN 37361-3645 |
| Bethany Randolph Hogan | Nurse Practitioner | Bradley-polk Walk-in Clinic | 119 White Water Dr, Ocoee, TN 37361-3645 |
| Stacy K Whitehead | Nurse Practitioner | Bradley-polk Walk-in Clinic | 119 White Water Dr, Ocoee, TN 37361-3645 |
| Street Address |
119 WHITE WATER DR |
| City | OCOEE |
| State | TN |
| Zip | 37361-3645 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tami Brehen | Nurse Practitioner | Bradley-polk Walk-in Clinic | 119 White Water Dr, Ocoee, TN 37361-3645 |
| Bethany Randolph Hogan | Nurse Practitioner | Bradley-polk Walk-in Clinic | 119 White Water Dr, Ocoee, TN 37361-3645 |
| Stacy K Whitehead | Nurse Practitioner | Bradley-polk Walk-in Clinic | 119 White Water Dr, Ocoee, TN 37361-3645 |
| City | OCOEE |
| Zip Code | 37361 |
| Specialty | PULMONARY DISEASE |
| City + Specialty | OCOEE + PULMONARY DISEASE |
Please comment or provide details below to improve the information on Ahmad M. Ibrahimbacha.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.