MEDICARE: ASIM AHMED LAL MD

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	207L00000X	Anesthesiology Physician	2025-00497	NC
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207L00000X	Anesthesiology Physician	1.085365	CT

General Provider Information

NPI Number	:	1508442385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASIM AHMED LAL MD

Provider Business Mailing Address
First Line	:	49 JESSE HILL JR DR SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30303-3049
Country	:	US
Telephone Number	:	404-778-7777
Fax Number	:

Provider Business Practice Location Address
First Line	:	4420 LAKE BOONE TRL
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-7505
Country	:	US
Telephone Number	:	919-784-3100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2021
Last Update Date	:	06/05/2026

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