Healthcare Provider Details

I. General information

NPI: 1861478356
Provider Name (Legal Business Name): IRAM F AHMED MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 09/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7880 LINCOLE PL
LISBON OH
44432-8322
US

IV. Provider business mailing address

7880 LINCOLE PL
LISBON OH
44432-8322
US

V. Phone/Fax

Practice location:
  • Phone: 330-424-7221
  • Fax:
Mailing address:
  • Phone: 330-424-7221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35083900
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: