Healthcare Provider Details

I. General information

NPI: 1215026620
Provider Name (Legal Business Name): ALIYA AHMED M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3294 POPLAR AVE STE 100
MEMPHIS TN
38111-4649
US

IV. Provider business mailing address

10773 WHISPER TRL
COLLIERVILLE TN
38017-8548
US

V. Phone/Fax

Practice location:
  • Phone: 901-362-8671
  • Fax: 901-458-4896
Mailing address:
  • Phone: 901-827-7821
  • Fax: 901-850-8057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number38830
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: