Healthcare Provider Details

I. General information

NPI: 1053332676
Provider Name (Legal Business Name): SYEDA S. AHMED MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. S. S. AHMED

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 W. WOOSTER STREET SUITE 216
BOWLING GREEN OH
43402-2650
US

IV. Provider business mailing address

960 W. WOOSTER STREET SUITE 216
BOWLING GREEN OH
43402-2650
US

V. Phone/Fax

Practice location:
  • Phone: 419-354-3123
  • Fax: 419-352-3939
Mailing address:
  • Phone: 419-354-3123
  • Fax: 419-352-3939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35042410
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: