Healthcare Provider Details

I. General information

NPI: 1194139451
Provider Name (Legal Business Name): MOHAMMAD AHMAD MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 10/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E CARROLL ST
SALISBURY MD
21801-5493
US

IV. Provider business mailing address

1150 VARNUM ST NE
WASHINGTON DC
20017-2104
US

V. Phone/Fax

Practice location:
  • Phone: 800-749-5191
  • Fax:
Mailing address:
  • Phone: 516-366-9898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD044904
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD86114
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: