Healthcare Provider Details

I. General information

NPI: 1689805764
Provider Name (Legal Business Name): AHMED ELAHMADY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 11/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2745 LINCOLN WAY
CLINTON IA
52732-7201
US

IV. Provider business mailing address

PO BOX 425
CLINTON IA
52733-0425
US

V. Phone/Fax

Practice location:
  • Phone: 563-242-3208
  • Fax: 563-242-4051
Mailing address:
  • Phone: 563-242-3208
  • Fax: 563-242-4051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StateIA

VIII. Authorized Official

Name: DR. AHMED ELAHMADY
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 563-242-3208