MEDICARE: WAHID MEDICAL PLLC

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	207R00000X	Internal Medicine Physician

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	:	1881116515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAHID MEDICAL PLLC

Provider Business Mailing Address
First Line	:	14728 HILLSIDE AVE
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11435-3329
Country	:	US
Telephone Number	:	718-487-3671
Fax Number	:	718-487-3715

Provider Business Practice Location Address
First Line	:	14728 HILLSIDE AVE
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11435-3329
Country	:	US
Telephone Number	:	718-487-3671
Fax Number	:	718-487-3715

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MOHAMMED A. WAHID
Credential	:	MD
Telephone Number	:	646-726-7301

Provider Enumeration Date	:	07/14/2017
Last Update Date	:	07/21/2022

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