Healthcare Provider Details

I. General information

NPI: 1154399715
Provider Name (Legal Business Name): SYED RAFEEQ AHMED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3903 PEACH ST
FLORENCE AL
35630-2803
US

IV. Provider business mailing address

3903 PEACH ST
FLORENCE AL
35630-2803
US

V. Phone/Fax

Practice location:
  • Phone: 256-766-3003
  • Fax: 256-766-0898
Mailing address:
  • Phone: 256-766-3003
  • Fax: 256-766-0898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number15555
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: