Healthcare Provider Details

I. General information

NPI: 1740920891
Provider Name (Legal Business Name): NAZIM JAMAL AHMED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6651 SILVER CREST RD STE 101
BATH PA
18014-8906
US

IV. Provider business mailing address

6651 SILVER CREST RD STE 101
BATH PA
18014-8906
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-7265
  • Fax:
Mailing address:
  • Phone: 484-526-7265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD491461
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: