MEDICARE: AHMAD CARDIOLOGY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	36611	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174634133
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AHMAD CARDIOLOGY INC

Provider Business Mailing Address
First Line	:	6400 CLAYTON RD
Second Line	:	SUITE 316
City	:	RICHMOND HEIGHTS
State	:	MO
Zip	:	63117-1850
Country	:	US
Telephone Number	:	314-644-2333
Fax Number	:	314-644-1577

Provider Business Practice Location Address
First Line	:	6400 CLAYTON RD
Second Line	:	SUITE 316
City	:	RICHMOND HEIGHTS
State	:	MO
Zip	:	63117-1850
Country	:	US
Telephone Number	:	314-644-2333
Fax Number	:	314-644-1577

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	JORGE J HERNANDEZ
Credential	:	M.D.
Telephone Number	:	314-644-2333

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	04/09/2008

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