Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wael S Ibrahim, MD

Individual provider Dermatopathology (Pathology) Physician · NPI 1376033563

Wael S Ibrahim, MD is a Pathology in Roseville, Minnesota. Qualified in 2014, 12 years ago. Practices with Tareen Dermatology PA, a 44-clinician group. Licensed in Minnesota and Wisconsin.

Years since qualifying
12
Licensed in
MN, WI
In the registry since
2018
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2720 Fairview Ave N Ste 200
Roseville, MN 55113-1306
Phone: (651) 633-6883
Fax: (651) 331-3459
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatopathology (Pathology) Physician (primary) Taxonomy 207ZD0900X · Licence 79808 (MN)
Dermatopathology (Pathology) Physician Taxonomy 207ZD0900X · Licence 85806-20 (WI)

Record details

NPI number1376033563
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 14, 2018
Last updated in NPPESDecember 4, 2025
Certification dateDecember 4, 2025
Mailing address2720 Fairview Ave N Ste 200, Roseville, MN 55113-1306

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Tareen Dermatology Pa — 44 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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