Healthcare Provider Details

I. General information

NPI: 1497858591
Provider Name (Legal Business Name): SAJID AHMED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 W 4TH NORTH ST
MORRISTOWN TN
37814-3894
US

IV. Provider business mailing address

619 S 8TH ST STE 301
GRIFFIN GA
30224-4260
US

V. Phone/Fax

Practice location:
  • Phone: 423-492-6100
  • Fax:
Mailing address:
  • Phone: 470-267-1970
  • Fax: 470-986-7053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number048202
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: