Healthcare Provider Details

I. General information

NPI: 1386615433
Provider Name (Legal Business Name): AHMAD M SLIM M.D.,
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: AHMAD M SLIM M.D.

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 03/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 SOUTH CEDAR ST SUITE 301
TACOMA WA
98405
US

IV. Provider business mailing address

315 MARTIN LUTHER KING JR WAY #8648
TACOMA WA
98405-4234
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-6113
  • Fax: 504-988-7795
Mailing address:
  • Phone: 253-459-8231
  • Fax: 253-459-7863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD12953
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberM4947
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD.207396
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD60685473
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: