MEDICARE: MASOOD AHMAD

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	207KA0200X	Allergy Physician	35057646A	OH

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
2	000000028740	OTHER	OH	ANTHEM

General Provider Information

NPI Number	:	1437303641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MASOOD AHMAD

Provider Business Mailing Address
First Line	:	6964 TYLERSVILLE RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-1511
Country	:	US
Telephone Number	:	513-777-7097
Fax Number	:	513-777-0841

Provider Business Practice Location Address
First Line	:	6964 TYLERSVILLE RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-1511
Country	:	US
Telephone Number	:	513-777-7097
Fax Number	:	513-777-0841

Authorized Official
Title or Position	:	OWNER
Name	:	MASOOD AHMAD
Credential	:	M.D.
Telephone Number	:	513-777-7097

Provider Enumeration Date	:	11/14/2008
Last Update Date	:	11/14/2008

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Directions to “MASOOD AHMAD ” Practice Location

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