Healthcare Provider Details

I. General information

NPI: 1376501312
Provider Name (Legal Business Name): NAVEEDA TABASSUM AHMED MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 MEDICAL CENTER DR STE 2B
AUGUSTA GA
30909-6675
US

IV. Provider business mailing address

1109 MEDICAL CENTER DR STE 2B
AUGUSTA GA
30909-6675
US

V. Phone/Fax

Practice location:
  • Phone: 706-305-9500
  • Fax: 706-305-9502
Mailing address:
  • Phone: 706-305-9500
  • Fax: 706-305-9502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number047287
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number047287
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: