Healthcare Provider Details

I. General information

NPI: 1194232546
Provider Name (Legal Business Name): HAMZA AHMED
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2018
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2845 SUGAR HILL RD STE 10
MARION NC
28752-6891
US

IV. Provider business mailing address

PO BOX 1490
BOONE NC
28607-1490
US

V. Phone/Fax

Practice location:
  • Phone: 828-398-0120
  • Fax: 828-570-0120
Mailing address:
  • Phone: 828-262-3886
  • Fax: 828-265-4816

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 State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: