Healthcare Provider Details

I. General information

NPI: 1801830385
Provider Name (Legal Business Name): JAMIL AHMED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HUNTINGTON WAY STE 100
FAIRMONT WV
26554-8819
US

IV. Provider business mailing address

1 HUNTINGTON WAY STE 100
FAIRMONT WV
26554-8819
US

V. Phone/Fax

Practice location:
  • Phone: 304-598-2801
  • Fax: 304-599-6463
Mailing address:
  • Phone: 304-598-2801
  • Fax: 304-599-6463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number21160
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: