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NPI Code Detail

MEDICARE: DR. AHMAD S AHMADZAI MD

MEDICARE: DR. AHMAD S AHMADZAI 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
1207R00000XInternal Medicine Physician01032690IN
2207R00000XInternal Medicine Physician01032690AIN

Other Identifiers

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

General Provider Information

NPI Number : 1598756819
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AHMAD S AHMADZAI MD
Provider Business Mailing Address
First Line : 9660 WICKER AVE
Second Line :
City : ST JOHN
State : IN
Zip : 46373-9487
Country : US
Telephone Number : 219-226-2203
Fax Number : 219-226-2202
Provider Business Practice Location Address
First Line : 6924 INDIANAPOLIS BOULEVARD
Second Line :
City : HAMMOND
State : IN
Zip : 46324-2206
Country : US
Telephone Number : 219-844-9060
Fax Number : 219-844-6912
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2005
Last Update Date : 07/09/2010

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