Healthcare Provider Details

I. General information

NPI: 1275970501
Provider Name (Legal Business Name): AHMED M SAFA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: AHMED S MAHMOOD MD

II. Dates (important events)

Enumeration Date: 05/28/2013
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 INDEPENDENCE DR
KENNEBUNK ME
04043-6078
US

IV. Provider business mailing address

PO BOX 911
BRATTLEBORO VT
05302-0911
US

V. Phone/Fax

Practice location:
  • Phone: 207-303-3300
  • Fax: 207-250-2144
Mailing address:
  • Phone: 207-303-3200
  • Fax: 978-524-7917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number283554
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number283554
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number38893
License Number StateNH
# 4
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD30064
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: