Healthcare Provider Details

I. General information

NPI: 1427213834
Provider Name (Legal Business Name): NEYAZ AHMAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2008
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 VFW PKWY
WEST ROXBURY MA
02132-4927
US

IV. Provider business mailing address

158 MOUNTAIN ST
SHARON MA
02067-2239
US

V. Phone/Fax

Practice location:
  • Phone: 857-203-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number246067
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: