Healthcare Provider Details

I. General information

NPI: 1427291210
Provider Name (Legal Business Name): AISHA AHMED M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2009
Last Update Date: 06/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 W WISCONSIN AVE CHILDREN'S CORPORATE CENTER SUITE 430
MILWAUKEE WI
53226-4874
US

IV. Provider business mailing address

1825 4TH ST
SAN FRANCISCO CA
94143-2350
US

V. Phone/Fax

Practice location:
  • Phone: 414-337-7030
  • Fax: 414-337-7068
Mailing address:
  • Phone: 415-353-7337
  • Fax: 415-502-2107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1010976
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: